Cable driven surgical stapling and cutting instrument with apparatus for preventing inadvertant cable disengagement

ABSTRACT

A cable driven surgical instrument that has an elongate channel assembly that is constructed to operably support a staple cartridge assembly therein. The instrument may have a knife assembly that is oriented for travel within the elongate channel assembly and at least one cable transition support that is operably mounted to at least one of the elongate channel assembly and the knife assembly. A drive cable operably extends around at least a portion of the cable transition support and interfaces with a cable drive system to drive the knife assembly within the elongate channel. A cable retention arrangement may be included for retaining the drive cable around at least a portion of the cable transition support.

The present application is related to the following commonly-owned U.S.Patent Applications filed on even date herewith, the disclosures ofwhich are hereby incorporated by reference in their entirety:

(1) U.S. patent application entitled “Surgical Stapling and CuttingInstrument With Improved Firing System” to Richard W. Timm, Frederick E.Shelton, IV, Eugene L. Timperman, and Leslie M. Fugikawa, (Docket No.END6094/KLG No. 070064);

(2) U.S. patent application entitled “Surgical Stapling and CuttingInstrument With Improved Closure System” to Richard W. Timm, FrederickE. Shelton, IV, Eugene L. Timperman, and Leslie M. Fugikawa, (Docket No.END6095USNP/KLG. No. 070065);

(3) U.S. patent application entitled “Cable Driven Surgical Stapling andCutting Instrument With Improved Cable Attachment Arrangements” toFrederick E. Shelton, IV and Richard W. Timm, (Docket No.END6097USNP/KLG. No. 070067);

(4) U.S. patent application entitled “Surgical Stapling and CuttingInstrument With Improved Anvil Opening Features” to Richard W. Timm,Frederick E. Shelton, IV, and Jeffrey S. Swayze, (Docket No.END6098USNP/KLG No. 070068); and

(5) U.S. patent application entitled “Surgical Stapling and CuttingInstruments” to Richard W. Timm, Frederick E. Shelton, IV, Charles J.Scheib, Christopher J. Schall, Glen A. Armstrong, Eugene L. Timperman,and Leslie M. Fugikawa, (Docket No. END6102USNP/KLG. No. 070071).

FIELD OF THE INVENTION

The present invention relates in general to endoscopic surgicalinstruments including, but not limited to, surgical stapler instrumentsthat are capable of applying lines of staples to tissue while cuttingthe tissue between those staple lines and, more particularly, toimprovements relating to firing and drive systems therefor.

BACKGROUND

Endoscopic surgical instruments are often preferred over traditionalopen surgical devices since a smaller incision tends to reduce thepost-operative recovery time and complications. Consequently,significant development has gone into a range of endoscopic surgicalinstruments that are suitable for precise placement of a distal endeffector at a desired surgical site through a cannula of a trocar. Thesedistal end effectors engage the tissue in a number of ways to achieve adiagnostic or therapeutic effect (e.g., endocutter, grasper, cutter,staplers, clip applier, access device, drug/gene therapy deliverydevice, and energy device using ultrasound, RF, laser, etc.).

Known surgical staplers include an end effector that simultaneouslymakes a longitudinal incision in tissue and applies lines of staples onopposing sides of the incision. The end effector includes a pair ofcooperating jaw members that, if the instrument is intended forendoscopic or laparoscopic applications, are capable of passing througha cannula passageway. One of the jaw members receives a staple cartridgehaving at least two laterally spaced rows of staples. The other jawmember defines an anvil having staple-forming pockets aligned with therows of staples in the cartridge. The instrument commonly includes aplurality of wedges that, when driven distally, pass through openings inthe staple cartridge and engage drivers supporting the staples to effectthe firing of the staples toward the anvil.

An example of such surgical staplers is disclosed in U.S. PatentPublication No. US 2006/0011699 A1 to Olson et al., the disclosure ofwhich is herein incorporated by reference. The stapling devicesdisclosed therein employs a cable or cables that are positioned arounddistally located pins or pulleys and are fixed to the knife. The ends ofthe cables are pulled in a proximal direction. Such system, however,suffers from a low mechanical advantage and tends to require relativelyhigh forces to pull the knife through its stroke.

Thus, there is a need for an improved drive and firing system for usewith cable driven surgical staplers.

In addition, such cable fired surgical stapler systems may suffer fromthe inadvertent disengagement of the cable from the pulley system whichmay disable the device. This condition may be caused by mechanicalvibration during use or other shock forced encountered during use orshipping.

Thus, there is another need for apparatuses, devices and systems forensuring that the cable or cables used to fire a surgical staplingdevice do not become disengaged from their respective pulleys or drivemembers.

SUMMARY

In one aspect of the invention, there is provided a surgical instrumentcomprising an elongate channel assembly that has a distal end and aproximal end and is constructed to operably support a staple cartridgeassembly therein. The instrument may further comprise a knife assemblythat is oriented for travel within the elongate channel assembly. Atleast one cable transition support may be operably mounted to at leastone of the elongate channel assembly and the knife assembly. A drivecable may extend around at least a portion of at least one cabletransition support and interface with a cable drive system to drive theknife assembly within the elongate channel. The instrument may furthercomprise a cable retention arrangement for retaining the drive cablearound at least a portion of the cable transition support.

In another general aspect of various embodiments of the presentinvention there is provided a surgical instrument comprising an elongatechannel assembly that has a distal end and a proximal end and isconstructed to operably support a staple cartridge therein. A knifeassembly may be oriented for travel within the elongate channelassembly. First and second distal cable transition supports may beprovided on the distal end of the elongate channel assembly. A secondcable transition support may be provided on the knife assembly. A drivecable may extend around at least a portion of the first and seconddistal cable transition supports and the second cable transition supporton the knife assembly and interface with a cable drive system to drivethe knife assembly within the elongate channel assembly. At least onecable retention arrangement for retaining the drive cable around atleast one of the first and second distal cable transition support andthe second cable transition support may be provided.

These and other objects and advantages of the present invention shall bemade apparent from the accompanying drawings and the descriptionthereof.

BRIEF DESCRIPTION OF THE FIGURES

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments of the invention,and, together with the general description of the invention given above,and the detailed description of the embodiments given below, serve toexplain various principles of the present invention.

FIG. 1 is a perspective view of a surgical stapling and severinginstrument of various embodiments of the present invention.

FIG. 2 is an exploded perspective view of a tool assembly depicted inFIG. 1.

FIG. 3 is a right perspective view of the tool assembly of FIG. 1 withsome components thereof shown in cross-section.

FIG. 4 is a left side partial cross-sectional view of the tool assemblydepicted in FIGS. 2 and 3.

FIG. 5 is a bottom perspective view with some parts separated therefromof a cartridge assembly of various embodiments of the present invention.

FIG. 6 is an exploded assembly view of a sled, staples and staplepushers of various embodiments of the present invention.

FIG. 7 is a perspective view of an anvil assembly of various embodimentsof the present invention.

FIG. 8 is a perspective view of a dynamic clamping member of variousembodiments of the present invention.

FIG. 9 is a side cross-sectional view of the tool assembly depicted inFIGS. 1-4 with tissue clamped therein.

FIG. 10 is a bottom perspective view of an elongate channel assembly ofvarious embodiments of the present invention.

FIG. 11 is a perspective view of a proximal portion of the elongatechannel assembly of FIG. 10.

FIG. 12 is a perspective view of distal portion of the elongate channelassembly of FIGS. 10 and 11.

FIG. 13 is a cross-sectional elevational view of a distal portion of theelongate channel assembly of FIGS. 10-12 with the dynamic clampingmember supported therein.

FIG. 14 is another bottom view of the elongate channel assembly of FIGS.10-13.

FIG. 15 is a diagrammatic side view of a firing system of variousembodiments of the present invention.

FIG. 15A is a diagrammatic view of another firing system of variousembodiments of the present invention.

FIG. 16 is a diagrammatic top view of the firing system of FIG. 15.

FIG. 16A is a diagrammatic view of the firing system of FIG. 15A.

FIG. 17 is a front perspective view of a winch assembly of variousembodiments of the present invention.

FIG. 18 is a rear perspective view of the winch assembly embodiment ofFIG. 17.

FIG. 19 is a right side elevational view of the winch assemblyembodiment of FIGS. 17 and 18.

FIG. 20 is a cross-sectional view of the winch assembly embodiment ofFIGS. 17-19 in a neutral position.

FIG. 21 is a perspective view of a drive system embodiment of thepresent invention.

FIG. 22 is a partial cross-sectional view of another embodiment of thepresent invention that employs an articulation joint.

FIG. 23 is an enlarged partial cross-sectional view of the articulationjoint depicted in FIG. 22.

FIG. 24 is an enlarged cross-sectional view of a portion of theinstrument depicted in FIG. 22.

FIG. 25 is a bottom view of another elongate channel assembly embodimentof the present invention.

FIG. 26 is an enlarged view of a distal end portion of the elongatechannel assembly of FIG. 25.

FIG. 27 is a cross-sectional view of a portion of the distal end of theelongate channel assembly of FIG. 26 taken along line 27-27 in FIG. 26.

FIG. 28 is a portion of a bottom view of a distal end of anotherelongate channel assembly embodiment of the present invention with somecomponents shown in cross-section.

FIG. 29 is a cross-sectional view of the portion of the elongate channelassembly depicted in FIG. 28 taken along line 29-29 in FIG. 28.

FIG. 30 is a diagrammatical top view of another cable arrangement thatemploys a cable tensioning joint of various embodiments of the presentinvention.

FIG. 31 is another diagrammatical top view of the cable arrangement ofFIG. 30 with the cable tensioning joint in a fully expanded position.

FIG. 32 is another diagrammatical top view of the cable arrangement ofFIGS. 30 and 31 in an articulated position.

FIG. 33 is an enlarged partial view of the cable tensioning jointdepicted in FIGS. 30-32.

FIG. 34 is a perspective view of a cable embodiment of the presentinvention.

FIG. 35 is an enlarged view of a cable attachment joint embodiment ofthe present invention.

FIG. 36 is a cross-sectional view of a cable anchor joint embodiment ofthe present invention attached to a dynamic clamping assembly.

FIG. 37 is a perspective view of the cable anchor joint of FIG. 36.

FIG. 38 is a cross-sectional view of another cable anchor jointembodiment of the present invention attached to a dynamic clampingassembly.

FIG. 39 is a partial view of another cable attachment embodiment of thepresent invention.

FIG. 40 is a partial view of another cable attachment embodiment of thepresent invention.

FIG. 41 is a partial perspective view of an articulation jointarrangement.

FIG. 42 is a perspective view of a closure tube joint assemblyembodiment of the present invention.

FIG. 43 is a cross-sectional view of the closure tube joint assemblyembodiment of FIG. 42 taken along line 43-43.

FIG. 44 is a perspective view of the closure tube joint assembly ofFIGS. 42 and 43 installed over the articulation joint depicted in FIG.41.

FIG. 44A is a perspective view of another closure tube joint assemblyembodiment of the present invention installed over the articulationjoint of FIG. 41.

FIG. 45 is a perspective view of another anvil assembly embodiment ofthe present invention.

FIG. 46 is an exploded perspective view of a handle assembly and aclosure tube actuation arrangement of an embodiment of the presentinvention.

FIG. 47 is a partial cross-sectional view of a handle assembly and toolassembly of an embodiment of the present invention, with some componentsthereof shown in solid view and the anvil assembly in a closed orclamped position.

FIG. 48 is a partial cross-sectional view of a closure tube assembly anda tool assembly of an embodiment of the present invention with the anvilassembly in a closed or clamped position.

FIG. 49 is another partial cross-sectional view of the handle assemblyand tool assembly of FIG. 47 with the anvil assembly thereof in an openposition.

FIG. 50 is another partial cross-sectional view of the closure tubeassembly and tool assembly of FIG. 48 with the anvil assembly thereof inan open position.

FIG. 51 is a partial cross-sectional view of a closure tube and aclosure ring of another embodiment of the present invention.

FIG. 52 is a partial perspective cross-sectional view of a universalarticulation joint arrangement of another embodiment of the presentinvention.

FIG. 53 is a cross-sectional view of a tool assembly and articulationjoint of FIG. 52.

FIG. 54 is a top view of the tool assembly and articulation joint ofFIG. 53.

FIG. 55 is a cross-sectional view of another universal articulationjoint of another embodiment of the present invention.

FIG. 56 is a perspective view of a cable controlled lockablearticulation joint embodiment of the present invention.

FIG. 57 is an end view of the cable controlled lockable articulationjoint embodiment of FIG. 56.

FIG. 58 is a cross-sectional view of another cable controlled lockablearticulation joint of another embodiment of the present invention.

FIG. 59 is a partial perspective end view of a proximal spine segment ofthe cable-controlled lockable articulation joint of FIG. 58.

FIG. 60 is an end view of the proximal spine segment of FIG. 59.

FIG. 61 is a partial side view of the proximal spine segment of FIGS. 59and 60.

FIG. 62 a cross-sectional view of another lockable articulation joint ofanother embodiment of the present invention.

FIG. 63 is a partial perspective end view of a proximal spine segment ofthe lockable articulation joint of FIG. 62.

FIG. 64 is an end view of the proximal spine segment of FIG. 63.

FIG. 65 a cross-sectional view of another lockable articulation joint ofanother embodiment of the present invention.

FIG. 66 is a partial perspective end view of a proximal spine segment ofthe lockable articulation joint of FIG. 65.

FIG. 67 is an end view of the proximal spine segment of FIG. 66.

FIG. 68 a cross-sectional view of another lockable articulation joint ofanother embodiment of the present invention.

FIG. 69 is a partial perspective end view of a proximal spine segment ofthe lockable articulation joint of FIG. 68.

FIG. 70 is an end view of the proximal spine segment of FIG. 69.

FIG. 71 a cross-sectional view of another lockable articulation joint ofanother embodiment of the present invention.

FIG. 72 a cross-sectional view of another lockable articulation joint ofanother embodiment of the present invention.

FIG. 73A is a partial cross-sectional view of a tool assembly andarticulation joint of another surgical instrument embodiment of thepresent invention.

FIG. 73B is a partial cross-sectional view of the closure tube assemblyof the surgical instrument of FIG. 73A.

FIG. 74A is another partial cross-sectional view of a tool assembly andarticulation joint of the surgical instrument of FIGS. 73A and 73B.

FIG. 74B is another partial cross-sectional view of the closure tubeassembly of the surgical instrument of FIGS. 73A and 73B.

FIG. 75 is a cross-sectional view through the closure tube assemblydepicted in FIG. 74A taken along line 75-75 in FIG. 74A.

FIG. 76 is another cross-sectional view of the closure tube assemblydepicted in FIG. 74B taken along line 76-76 in FIG. 74B.

FIG. 77 is another cross-sectional view of the closure tube assemblydepicted in FIG. 74B taken along line 77-77 in FIG. 74B.

FIG. 78 is a partial exploded assembly view of a quick disconnect jointof an embodiment of the present invention with the components thereofshown in cross-section.

FIG. 79 is another partial exploded assembly view of the quickdisconnect joint of FIG. 78.

FIG. 80 is another partial exploded assembly view of the quickdisconnect joint of FIGS. 78 and 79.

FIG. 81 is another partial exploded assembly view of the quickdisconnect joint of FIGS. 78-80.

FIG. 82 is a cross-sectional view of another handle assembly embodimentof the present invention.

FIG. 83 is a diagrammatic end view of a drive system of variousembodiments of the present invention.

FIG. 84 is a partial perspective view of a brake release mechanism ofvarious embodiments of the present invention.

FIG. 85 is a partial perspective view of another articulation jointembodiment of various embodiments of the present invention.

FIG. 86 is an exploded assembly view of the articulation joint of FIG.85.

FIG. 87 is a partial side elevational view of the articulation joint ofFIGS. 85 and 86.

FIG. 88 is a top view of the articulation joint of FIG. 87.

FIG. 89 is another top view of the articulation joint of FIGS. 87 and 88in an articulated position.

FIG. 90 is a partial perspective view of another tool assembly andclosure tube arrangement of various embodiments of the present inventionwith a portion of the closure tube shown in cross-section.

FIG. 91 is a cross-sectional elevational view of the tool assembly andclosure tube arrangement of FIG. 90 with the trunnion lock bar in alocked position retaining the trunnions in their respective slots.

FIG. 92 is a partial top view of the tool assembly and closure tubearrangement of FIG. 91 with portions thereof shown in cross-section.

FIG. 93 is a cross-sectional elevational view of the tool assembly andclosure tube arrangement of FIGS. 90-92 with the trunnion lock bar in anunlocked position.

FIG. 94 is a partial top view of the tool assembly and closure tubearrangement of FIG. 93 with portions thereof shown in cross-section.

FIG. 95 is a cross-sectional elevational view of the tool assembly andclosure tube arrangement of FIGS. 90-92 with the trunnion lock bar in anunlocked position and the trunnions moved out of the trunnion slots inthe elongate channel assembly.

FIG. 96 is a side elevational view of a dynamic clamping assembly ofvarious embodiments of the present invention.

FIG. 97 is a side elevational view of another dynamic clamping assemblyof various embodiments of the present invention.

FIG. 98 is a side elevational view of another dynamic clamping assemblyof various embodiments of the present invention.

FIG. 99 is a side elevational view of another dynamic clamping assemblyof various embodiments of the present invention.

FIG. 100 is another side elevational view of the dynamic clampingassembly of FIG. 99 after the slot has been opened and the pin removed.

FIG. 101 is a side elevational view of another dynamic clamping assemblyof various embodiments of the present invention.

FIG. 102 is a side elevational view of another dynamic clamping assemblyof various embodiments of the present invention.

FIG. 103 is a partial cross-sectional view of the dynamic clampingassembly of FIG. 102 taken along line 1030-103 in FIG. 102.

FIG. 104 is a side elevational view of a portion of another surgicalinstrument embodiment of the present invention with a closure ring movedin its distal-most position and with some components thereof shown incross-section.

FIG. 105 is a side elevational view of the surgical instrumentembodiment of FIG. 104 with the closure ring moved in its proximal-mostposition and with some components thereof shown in cross-section.

DETAILED DESCRIPTION

Certain exemplary embodiments will now be described to provide anoverall understanding of the principles of the structure, function,manufacture, and use of the devices and methods disclosed herein. One ormore examples of these embodiments are illustrated in the accompanyingdrawings. Those of ordinary skill in the art will understand that thedevices and methods specifically described herein and illustrated in theaccompanying drawings are non-limiting exemplary embodiments and thatthe scope of the various embodiments of the present invention is definedsolely by the claims. The features illustrated or described inconnection with one exemplary embodiment may be combined with thefeatures of other embodiments. Such modifications and variations areintended to be included within the scope of the present invention.

Turning to the Drawings, wherein like numerals denote like componentsthroughout the several views, FIG. 1 depicts a surgical instrument,which in the illustrative versions is more particularly a surgicalstapling and severing instrument 1, capable of practicing certain uniquebenefits of the present invention. Instrument 1 may essentially comprisea surgical stapler of the form and construction disclosed in thepreviously cited U.S. Patent Publication No. 2006/0011699 A1, which hasbeen herein incorporated by reference in its entirety, with one or moreof the improvements described below. As the present Detailed Descriptionproceeds, however, those of ordinary skill in the art will appreciatethat the various embodiments and improvements described herein may beincorporated in connection with other surgical stapler constructionswithout departing from the spirit and scope of the present invention.

As shown in FIG. 1, the instrument 1 may include a housing 3 that hasdistal and proximal ends 4 and 6, respectively, an elongated shaft 20mounted to housing 3, preferably to its distal end 4, and a handleassembly generally designated as 5. Shaft 20 may have a distal end 20 ato which may be operatively attached by attachment mechanism 20 b to adisposable loading unit 10. As also shown in FIG. 1, disposable loadingunit (DLU) 10 may comprise a tool assembly 100 and a shaft connectorportion 20 c which may be pivotally and operatively attached to eachother through connector mechanism C.

It is within the scope of this disclosure that tool assembly 100 may bepivotally, operatively, or integrally attached, for example, through aconnection mechanism such as C permanently and directly to distal end 20a of shaft 20 of a disposable surgical stapler. As is known, a used orspent disposable loading unit 10 can be removed from shaft 20 of areusable or disposable open, endoscopic or laparoscopic surgicalstapler, and replaced with an unused disposable unit. In variousembodiments, it is contemplated that shaft 20 with or without anintegral or removably attached disposable loading unit can beselectively removable from the housing 3.

Shaft connector portion 20 c includes a proximal end 24 and a distal end22. As mentioned above, the proximal end 24 can be permanently orremovably associated with a handle or other actuating assemblies of amanually (or other, e.g., robotic or computer) operated open orendoscopic surgical stapler 1. Distal end 22 of shaft connector portion20 c is operatively connected to tool assembly 100. Tool assembly 100,in general, may include an elongate channel assembly 120, an anvilassembly 110, and a staple cartridge assembly 200. Tool assembly 100 mayalso preferably include an actuator, preferably a dynamic clampingmember 150, a sled 160, as well as staple pushers 228 and staples 350once an unspent or unused cartridge 200 is mounted in elongate channelassembly 120. See FIGS. 2, 5, and 6.

It will be appreciated that the terms “proximal” and “distal” are usedherein with reference to a clinician gripping a handle of an instrument.Thus, the tool assembly 100 is distal with respect to the more proximalhandle assembly 5. It will be further appreciated that, for convenienceand clarity, spatial terms such as “vertical” and “horizontal” are usedherein with respect to the drawings. However, surgical instruments areused in many orientations and positions, and these terms are notintended to be limiting and absolute.

Shaft connector portion 20 c may be cylindrical in shape and define aninternal channel 25 which may be dimensioned to receive a tube adapter40. See FIG. 2. Shaft connector portion 20 c may also receive or houseactuators for actuating tool assembly 100. Tool assembly 100 may mountto distal end 22 of shaft connector 20 c (or the distal end 20 a ofshaft 20). In various embodiments, tool assembly 100 may be mounted ontotube adapter 40 which includes an outer cylindrical surface 47 that maybe slidingly received in friction-fit engagement with the internalchannel 25 of shaft connector 20 c (or, again, to shaft 20). Herein, thedescription of the proximal connection or attachment of tool assembly100 to shaft connector 20 c may also apply to its connection to shaft20. The outer surface 47 of the tube adapter 40 may further include atleast one mechanical interface, e.g., a cutout or notch 45, oriented tomate with a corresponding mechanical interface, e.g., a radiallyinwardly extending protrusion or detent (not shown), disposed on theinner periphery of internal channel 25 to lock the tube adapter 40 tothe shaft connector 20 c.

In various embodiments, the distal end of tube adapter 40 may include apair of opposing flanges 42 a and 42 b which define a cavity 41 forpivotably receiving a pivot block 50 therein. Each flange 42 a and 42 bmay include an aperture 44 a and 44 b oriented to receive a pivot pin 57that extends through an aperture in pivot block 50 to allow pivotablemovement of pivot block 50 about a “Z” axis defined as perpendicular tolongitudinal axis “X” of tool assembly 100. See FIG. 3. As will beexplained in more detail below, the channel assembly may be formed withtwo upwardly extending flanges 121 a, 121 b that have an aperture 122 a,122 b, respectively, which are dimensioned to receive a pivot pin 59. Inturn, pivot pin 59 mounts through apertures 53 a, 53 b of pivot block 50to permit rotation of the tool assembly 100 about the “Y” axis as neededduring a given surgical procedure. Rotation of pivot block 50 about pin57 along “Z” axis rotates tool assembly 100 about the “Z” axis. Othermethods of fastening the channel 120 to the pivot block and of fasteningthe anvil to the channel may be effectively employed without departingfrom the spirit and scope of the present invention.

In various embodiments, an actuator or a plurality of actuators (notshown) preferably pass through shaft connector portion 20 c, tubeadapter 40, and pivot block 50 and operably connect to tool assembly 100to permit the surgeon to articulate tool assembly 100 about the “Y” and“Z” axes as needed during a surgical procedure. In addition, shaft 20 ofsurgical stapler 1 may be rotatable 360° by the rotation of knob “K”. Asa result, tool assembly 100 may be articulatable at least 90° in alldirections. Various actuators, hand assemblies, and pivot blocks areenvisioned which can be utilized to accomplish this task some of whichare identified in U.S. Pat. Nos. 6,250,532 and 6,330,965, the entirecontents of which are each hereby incorporated by reference herein.

As mentioned above, in various embodiments, tool assembly 100 mayinclude anvil assembly 110 and elongate channel assembly 120. See FIG.2. Elongate channel assembly 120 may support the staple cartridgeassembly 200, an actuator, e.g., a dynamic clamping member 150, and asled 160. As such, these various assemblies and their respectiveinternal components, when assembled, cooperate to allow the toolassembly to manipulate, grasp, clamp, fasten and, preferably, severtissue during a given surgical procedure as explained below. Elongatechannel assembly 120 may include a bottom surface 128 having upwardlyextending side walls or flanges 121 a and 121 b which define elongatedsupport channel 125 which, in turn, is dimensioned to mountingly receivestaple cartridge assembly 200 therein. Elongate channel assembly 120 mayalso include a plurality of mechanical interfaces 127 a, 127 b, 127 c,127 d oriented to receive a corresponding plurality of mechanicalinterfaces 235 a, 235 b, 235 c, and 235 d disposed in the outer-facingsurfaces of staple cartridge assembly 200. See FIGS. 2 and 6.

Staple cartridge assembly 200 mounts within the elongate channelassembly 120 and includes an upper tissue contacting or facing surface231 which, as will become further apparent as the present DetailedDescription proceeds, opposes a tissue contacting or facing bottom anvilsurface 114 b of anvil assembly 110. Staple cartridge assembly 200 canbe assembled and mounted within elongate channel assembly 120 during themanufacturing or assembly process and sold as part of overall toolassembly 100, or staple cartridge assembly 200 may be designed forselective mounting to channel assembly 120 as needed and soldseparately, e.g., as a single use replacement, replaceable or disposablestaple cartridge assembly 200. For example, staple cartridge assembly200 may be manufactured to include sled 160 and dynamic clamping member150. Alternatively dynamic clamping member 150 with a knife 155 may besold as part of the replaceable staple cartridge assembly 200 without aknife blade 155 a (but preferably with a knife blade 155 a) to enhanceand/or insure accurate cutting of tissue after staple formation. Toolassembly 100 may also be sold as a kit that includes a variety of staplecartridges 200 containing surgical fasteners 350 of different sizes,and/or arranged to be ejected in different patterns, any of which may beselectively-coupled to the elongate channel assembly 120 as desired foruse during a particular operation.

As best seen in FIG. 6, sled 160 may include a pair ofupwardly-extending cam wedges 161 a and 161 b which, when actuated tomove by the user, cam a series of surgical fasteners 350 or staples intoand through the tissue and against staple forming pockets 111 (shown inFIG. 9) of anvil assembly 110 to form the fasteners 350 and fastentissue therewith. Dynamic clamping member 150 is associated with, e.g.,mounted on and rides on, or with or is connected to or integral withand/or rides behind sled 160. It is envisioned that dynamic clampingmember 150 can have cam wedges or cam surfaces attached or integrallyformed or be pushed by a leading distal surface thereof.

In various embodiments, dynamic clamping member 150 may include an upperportion 157 having a transverse aperture 154 with a pin 159 mountable ormounted therein, a central support or upward extension 151 andsubstantially T-shaped bottom flange 152 which cooperate to slidinglyretain dynamic clamping member 150 along an ideal cutting path duringlongitudinal, distal movement of sled 160. See FIG. 8. The leadingcutting edge 155, here, knife blade 155 a, is dimensioned to ride withinslot 282 of staple cartridge assembly 200 and separate tissue 400 oncestapled. It is envisioned that leading edge 153 a of the dynamicclamping member 150 may be serrated, beveled or notched to facilitatetissue cutting. In some embodiments, for example, the upper cammingmember need not be a pin but can be any integral or removable suitableoutwardly protruding cam surface(s). The same applies to bottom flange152 which can be any suitable camming surface, including a pin or aremovable pin, a button to facilitate mounting of the dynamic clampingmember into the sled 160 or elongate channel assembly 120. As usedherein, the term “knife assembly” 170 may include the aforementioneddynamic clamping member 150, knife 155, and sled 160 or otherknife/beam/sled drive arrangements. In addition, the various embodimentsof the present invention may be employed with knife assemblyarrangements that may be entirely supported in the staple cartridge orpartially supported in the staple cartridge and elongate channelassembly or entirely supported within the elongate channel assembly.

As best shown in FIG. 10, the elongate channel assembly 120 has a distalend 123 and proximal end 123′. The bottom surface 128 of the elongatechannel assembly 120 also includes an elongated longitudinal slot 126which includes and communicates at its proximal end with a cut out ornotch 129. Notch 129 is dimensioned to allow bottom flange 152 ofdynamic clamping member 150 to pass therethrough. The narrower portionof slot 126 is dimensioned to slidingly receive and allow upward supportor extension 151 to pass therethrough. See FIG. 13. Other dynamicclamping members 150, channel slots, and sled configurations may beemployed.

When tool assembly 100 is assembled, sled 160 may be slidinglypositioned between the staple cartridge assembly 200 and the elongatechannel assembly 120 (See FIG. 3). Sled 160 and the inner-workingcomponents of staple cartridge assembly 200 detailed above operativelycooperate to deform staples 350. More particularly, as indicated above,sled 160 may include upwardly extending, bifurcated cam wedges 161 a and161 b which engage and cooperate with a series of staple pushers 228 todrive staples 350 through slots 225 from cartridge assembly 200 anddeform against staple forming pockets 11 of anvil assembly 100. Furtherdetails of a sled 160, dynamic clamping member 150 and the staplecartridge assembly 200 of various embodiments are further described inU.S. Publication No. US 2006/0011699 A1.

As shown in FIGS. 2 and 7, anvil assembly 110 may be elongated andinclude a proximal end 116, a distal end 118, and top and bottomsurfaces 114 a and 114 b, respectively. A pair of trunnions 119 a and119 b may be disposed near proximal end 116 and are designed forpivotable engagement with corresponding pair of notches 123 a and 123 bprovided in the sidewalls 121 a, 121 b near the proximal end of theelongate channel assembly 120. It is contemplated that actuation byconventional means (e.g., activated remotely, e.g., by a handle assembly5 will cause clamping collar 140 to move in a distal direction andengage forward cam surface 115 of anvil assembly 110. This will causethe anvil assembly 110 to pivot from an open first position wherein theanvil assembly 110 and the elongate channel assembly 120 are disposed inspaced relation relative to one another to a second closed positionwherein anvil assembly 110 and staple cartridge assembly 200 cooperateto grasp tissue therebetween, i.e., pre-clamp the tissue between tissueengaging surface 114 b of anvil assembly 110 and opposing tissueengaging surface 231 of staple cartridge assembly 200. However, otheranvil assembly arrangements may be successfully employed.

In various embodiments, anvil assembly 110 may include an elongatedcross or T-shaped channel or slot generally designated 112 having adepending central portion or leg 112 a and a transverse upper portion112 b. See FIG. 7. Slot 112 preferably extends longitudinally fromproximal end 113 of upper portion 114 a of the anvil assembly 110 to thedistal end 118 thereof. Leg 112 a starts from or enters proximal end 113of anvil assembly 110 and extends to distal end 118 and upper transverseportion 112 b starts proximal cam 115 and extends to distal end 118. SeeFIG. 7. Preferably, upper portion 112 b is dimensioned to slidinglyreceive transverse pin 159 that extends within aperture 154 in upperportion 157 of central support or extension 157 of dynamic clampingmember 150 (see FIG. 9). Pin 159 is dimensioned to slidingly lock theupper portion 157 of dynamic clamping member 150 within the T-shapedslot 112 such that the dynamic clamping member 150 islongitudinally-reciprocatable within slot 112.

In various embodiments, pre-clamping collar 140 may be designed toencompass and clamp or pre-clamp the channel assembly 120 and the anvilassembly 110 together in an approximated and clamped position prior totissue fastening. By moving pre-clamping collar 140 distally, the usercan actuate/move the anvil assembly 110 from an open, first positiontoward channel assembly 120 to approximate the jaws, i.e., the anvilassembly 110 and staple cartridge 200, to a second, closed position tograsp tissue therebetween. The sled 160 can be actuated by the user tostaple and subsequently incise the tissue.

As best illustrated by FIGS. 4, 8, and 9, during distal translation ofthe dynamic clamping member 150 through tissue 400, the combination ofthe heavy gauge material of the anvil assembly 110 and the substantiallyvertical alignment of the flange 152, knife edge 155, and camming pin159 operate to further proximate (i.e., further clamp) the opposingtissue engaging surfaces (i.e., anvil bottom surface 114 b and upperfacing surface 231 of staple cartridge assembly 200) at a moving pointwhich is distal to the leading edge 155 of the knife 155 a. The furtherclamping of the tissue 400 distally relative to the translating dynamicclamping member 150 acts to maintain a maximum acceptable gap betweenthe opposing surfaces 114 b and 231 and forces fluid from the tissue 400which may enhance stapling and reduce the likelihood of hydraulicallydisplacing the staples 350 during deformation. It is contemplated thatthe combination of the enhanced closure force as a result of the heavygauge material of the anvil assembly 110, together with the abovedescribed dynamic clamping member 150, permits relatively accuratecutting of tissue 400 when leading edge 155 is advanced through tissue400.

From the foregoing and with reference to the various Figures, thoseskilled in the art will appreciate that certain modifications can alsobe made to the present disclosure without departing from the scope ofthe present disclosure. For example, the above-described tool assembly100 may be part of or incorporated into a disposable loading unit (DLU)such as disclosed in U.S. Pat. No. 6,330,965 or attached directly to thedistal end of any known surgical stapling device. A handle assembly foractuating the approximation member(s) can be selected from a variety ofactuating mechanisms including toggles, rotatable and slideable knobs,pivotable levers or triggers, and any combination thereof. The use ofthe above-described tool assembly 100 as part of a robotic system isalso envisioned.

FIGS. 10-18 illustrate a single use tool assembly arrangement. As can beseen in those Figures, a pair of cables, ropes, threads, bands or belts800, 820 may be supported by the channel assembly 120. As can be seen inFIGS. 11 and 12, a first cable 800 may include an anchor segment 802that is fixed to a first point of attachment 803 on the bottom 128 ofthe elongate channel assembly 120 at the distal end 123 thereof, anactivation portion 804 that extends to the drive system (not shown)located in the housing portion 5, and a moving portion 805. As can bemost particularly seen in FIG. 12, the first cable 800 is operablysupported on a first distal cable transition support 830 that maycomprise, for example, a pulley, rod, capstan, etc. mounted to thebottom 128 at the distal end 123 of the elongate channel assembly 120.The first cable 800 may also be operably supported on a second cabletransition support 840, which may comprise, for example, a double pulley840 mounted to the knife assembly 170. In one embodiment, for example,the second cable transition support is mounted to the bottom flangeportion 152 of the dynamic clamping member 150. See FIGS. 12 and 13. Thefirst cable 800 may pass through a longitudinally extending first groove806 provided in the bottom 128 of the elongate channel assembly 120. Themoving portion 805 may move freely back and forth axially adjacent theslot 126. The activation portion 804 may pass through a first transitionpassage 808 in the bottom 128 of the elongate channel assembly 120 asshown in FIG. 11.

Also in this embodiment, a second cable 820 may have an anchor portion822 that is fixed to the bottom 128 of the elongate channel assembly 120at the distal end 123 thereof at a second point of attachment 803′, anactivation portion 824 that extends to the drive system located in thehandle housing 5, and a moving portion 825. The second cable 820 may beoperably supported on a second distal cable transition support 850 whichmay, for example, comprise a second pulley, rod, capstan, etc. that isattached to the distal end 123 of the elongate channel assembly 120 andis also operably supported on the second cable transition support 840.The second cable 820 may pass through a longitudinally extending secondgroove 826 provided in the bottom 128 of the elongate channel assembly120. The moving portion 825 may freely move back and forth axiallyadjacent the slot 126. The activation portion 824 may pass through asecond transition passage 828 in the bottom 128 of the elongate channelassembly 120. See FIG. 11. Those of ordinary skill in the art willappreciate that such arrangement may provide improved mechanicaladvantages over prior cable arrangements and thereby reduce the amountof firing forces that must be generated to advance the knife assembly170 in the form of the dynamic clamping member 150, knife 155, and sled160 to fire the staples 350.

As indicated above, the advancement and retraction of the knife assembly170 (i.e., dynamic clamping assembly 150, knife 155, and sled 160) iscontrolled by the cables 800, 820 that each have proximal ends which maybe attached, for example, to a cable drive system which may include, forexample, a rotatable take up drum or drums (not shown) operablysupported in the handle 5. The take up drum or drums may be mechanicallyor manually rotated or powered by a motor to rotate the cables 800, 820thereon. As the cables 800, 820 are taken up on those drums, the knifeassembly 170 (dynamic clamping assembly 150/sled 160 are driven from theproximal end of the elongate channel 120 to the distal end thereof tocomplete the severing and stapling operations. In various embodiments nomeans are provided to retract the knife assembly 170 back to theproximal end of the channel 120, so the tool assembly may not be reused.

An alternative firing system 1300 embodiment is disclosed in FIGS.15-20. As can be seen in FIGS. 15-17, this embodiment employs an advancecable 1302 that is bifurcated into a pair of advance cable portions1310, 1320 and a retract cable 1330 which are illustrated indiagrammatic form. As can be most particularly seen in FIG. 16, a firstadvance cable portion 1310 may be operably supported on a first distalcable transition support 1340 which may comprise, for example, a pulley,rod, capstan, etc. that is attached to the distal end 123 of theelongate channel assembly 120 as was described above. A distal end 1312of the first advance cable portion 1310 may be affixed to the knifeassembly 170 (dynamic clamping assembly 150). The second advance cableportion 1320 may be operably supported on a second distal cabletransition support 1360 which may, for example, comprise a pulley, rod,capstan etc. that is mounted to the distal end 123 of the elongatechannel assembly 120. A distal end 1322 of the second advance cableportion 1320 is attached to the knife assembly 170 (dynamic clampingassembly 150). Also in these embodiments, a retract cable 1330 isemployed. In one embodiment, the retract cable 1330 may be formed in aloop such that the distal looped end 1332 is fixedly attached (swaged,etc.) to the dynamic clamping assembly 150.

In various embodiments, the advance cable 1302 and the retract cable1330 may be driven by, for example, a cable drive system 1000 which, forexample, may comprise a manually actuatable winch assembly 1001 mountedin or otherwise supported by the handle assembly 5. See FIGS. 17-20. Thewinch assembly 1000 may include, for example, an actuator 1002 in theform of a firing trigger 1004 that is pivotally supported by the handleassembly 5. While this embodiment employs a grippable trigger 1004,those of ordinary skill in the art will appreciate that the actuator1002 may comprise a push button, lever, slide, etc. without departingfrom the spirit and scope of the present invention. In the embodimentdepicted in FIGS. 17-20, the winch assembly 1001 may include atransmission 1010 and first and second rotatable spools 1250, 1260,respectively, that are supported on a frame assembly 1012.

In various embodiments, a handle gear segment 1006 may be formed orotherwise provided on the firing trigger 1004. The handle gear segment1006 is mounted in meshing engagement with a primary drive gear 1040that is mounted to a shaft 1042 attached to a first ratchet clutch plate1052 of a clutch assembly 1050. See FIG. 18. A second ratchet clutchplate 1060 is supported on a clutch shaft 1062 that is rotatablysupported within the handle assembly 5. The clutch shaft 1062 may beprovided with a shoulder portion 1064 and have a clutch spring 1066journaled thereon and in contact with a portion of the housing 3 to biasthe second ratchet clutch plate 1060 into meshing engagement with thefirst ratchet clutch plate 1052. As can also be seen in FIG. 18, asecond drive gear 1070 is journaled on the clutch shaft 1062 and is inmeshing engagement with a third drive gear 1080 that is attached to afirst transmission shaft 1090 that is rotatably supported by a firsttransmission bearing or sleeve 1092 mounted in the frame assembly 1012.See FIG. 18. The first transmission shaft 1090 may have a first piniongear portion 1100 and a series of first gear teeth 1102 formed thereonfor selective meshing engagement with a series of primary gear teeth1112 on an axially and rotatably movable shaft spool 1110. As can beseen in FIG. 20, the shaft spool 1110 is received on a splined shaft1120 that is rotatably received within the first transmission shaft 1090and a second pinion gear 1130. The second pinion gear 1130 has a secondpinion gear portion 1132 and a series of second gear teeth 1134 forselective meshing engagement with secondary gear teeth 1114 on the shaftspool 1110. The second pinion gear 1130 may be rotatably supported by asecond bearing 1136 mounted 1136 in the frame assembly 1012 as shown. Ascan be seen in FIGS. 18 and 20, a reversing bevel gear 1140 is supportedby the frame assembly 1012 in meshing engagement with the first andsecond pinion gears 1100, 1130, respectively.

As can also be seen in FIGS. 18 and 20, the shaft spool 1110 may have acollar portion 1150 formed thereon for receiving two opposing pins 1162extending from a yoke 1160 formed on a bottom portion of a switch bar1166. The switch bar 1166 may have a shaft portion 1168 that ispivotally pinned to a crossbar portion 1014 of the frame assembly 1012.A portion of the shaft 1168 protrudes out through an opening in thehandle case (not shown) and a switch button 1170 may be attached to theend of the shaft 1168 to enable the user to shift the shaft 1168 axiallyback and forth to reverse the transmission 1010 as will be furtherdiscussed below. Those of ordinary skill in the art will appreciate thatthe yoke arrangement 1160 enables the shaft spool 1110 to freely rotaterelative to the yoke 1160 while enabling the yoke 1160 to shift theshaft spool 1110 axially on the splined shaft 1120.

As can be seen in FIG. 20, a shifter output gear 1180 is keyed orotherwise attached to the splined shaft 1120 for rotation therewith. Theshifter output gear 1180 is arranged in meshing engagement with a firstspool gear 1190 that is attached to the shaft 1200 of the firstrotatable spool 1250. Attached to the other end of the first rotatablespool shaft 1200 is a first spool transfer gear 1220. The first spooltransfer gear 1220 is in meshing engagement with a reversing gear 1230which is meshing engagement with a second spool drive gear 1240 that isattached to the shaft 1252 of the second rotatable spool 1260. See FIG.17. In various embodiments, the advance cable 1302 may be received onsecond (bottom) rotatable spool 1260 and the retraction cable 1330 maybe received on the first rotatable spool 1250.

A method of operating the winch 1000 will now be described withreference to FIGS. 17-20. Turning to FIG. 20 first, in that Figure, theshaft spool 1110 is in the neutral position. Thus, actuation of thefiring trigger 1004 will not result in any movement of the dynamicclamping member 150, knife 155 or sled 160. To fire the device (advancethe dynamic clamping member 150, knife 155, and sled 160 from theproximal end of the elongate channel assembly 120 to the distal end ofthe elongate channel assembly 120), the clinician shifts the shifterbutton 1170 to the position shown in FIG. 18. In doing so, the primarygear teeth 1112 of the shaft spool 1110 are brought into meshingengagement with the first gear teeth 1102 of the first pinion gear 1100.After the shaft spool 1110 has been moved to that position, theclinician may begin to pull/pivot the firing trigger 1004 to cause thehandle gear segmental 006 to move in the direction represented by arrow“A” in FIG. 18. As the firing trigger 1004 continues to pivot, the gearsegment 1006 rotates the primary drive gear 1040 as well as the clutchassembly 1050 and the second drive gear 1070 in the “B” direction. Asthe second drive gear 1070 rotates in that direction, the third drivegear 1080 is rotated in the opposite “A” direction which also causes thefirst pinion gear 1100 to rotate in that direction. Because the firstteeth 1102 of the first pinion gear 1100 are in meshing engagement withthe primary teeth 1112 of the shaft spool 1110, the shaft spool 1110also rotates in the “A” direction. As the shaft spool 1110 rotates inthe “A” direction, the splined shaft 1120 and the shifter output gear1180 also rotate in that direction. The shifter output gear 1180 is inmeshing engagement with the first spool gear 1190 that is attached tothe shaft 1200 of the first payout spool 1250. As the shifter outputgear is rotated in the “A” direction, the first spool gear 1190 isrotated in the “B” direction. The first spool transfer gear 1220 isattached to the shaft 1200 and also rotates in the “B” direction. As thefirst spool 1250 rotates in the “B” direction, the retract cable 1330 ispaid off of the first spool 1250. As the first spool rotates 1250, thefirst spool transfer gear 1220 rotates in the same direction. The firstspool transfer gear 1220, reversing gear 1230, and second spool drivegear 1240 cause the second spool 1260 to wind up the advance cable 1302thereon.

After the firing trigger 1004 has been depressed as far as it can go (tothe end of its stroke), the clinician releases the firing trigger 1004and a spring (not shown) or other suitable arrangement supported by thehandle assembly 5 biases the firing trigger back 1004 to the starting(unfired position). As the firing trigger 1004 returns to the startingposition, the first clutch plate 1052 rotates backwards (“A” direction)relative to the second clutch plate 1060 while the second clutch plate1060 remains stationary and does not move. The user can then depress thefiring trigger 1004 again until the dynamic clamping member 150, knife155, and sled 160 have been completely advanced to the end distalposition within the channel assembly 120 by the advance cable 1302.

To retract (move the knife assembly 170 in the proximal direction “PD”to a starting position) the dynamic clamping assembly 150, the knife155, and the sled 160 (knife assembly 170), the clinician shifts theshifter button 1170 to bring the secondary gear teeth 1114 of the shaftspool 1110 into meshing engagement with the second gear teeth 1134 onthe second pinion gear 1130. After the shaft spool 1110 has been movedto that position, the clinician may begin to pull/pivot the firingtrigger 1004 in the manner described above. As the firing trigger 1004continues to pivot, the gear segment 1006 rotates the primary drive gear1040 as well as the clutch assembly 1050 and the second drive gear 1070in the “B” direction. As the second drive gear 1070 rotates in thatdirection, the third drive gear 1080 is rotated in the opposite “A”direction which also causes the first pinion gear 1100 to rotate in thatdirection. As the first pinion gear 1100 rotates, it causes thereversing bevel gear 1140 to rotate and cause the second pinion gear1130 to rotate in the “B” direction. Because the secondary teeth 1114 ofthe shaft spool 1110 are in meshing engagement with the second teeth1134 of the second pinion gear 1130, the shaft spool 1110 and thesplined shaft 1120 rotate in the “B” direction. The shift output gear1180 causes the first spool transfer gear 1220 to rotate in the “A”direction. As the first spool transfer gear 1220 rotates in the “A”direction, the retract cable 1330 is wound onto the first spool 1250. Asthe first spool rotates 1250, the first spool transfer gear 1220 rotatesin the same direction. The first spool transfer gear 1220, reversinggear 1230 and second spool drive gear 1240 cause the second spool 1260to rotate to payout the advance cable 1302 therefrom.

After the firing trigger 1004 has been depressed as far as it can go (tothe end of its stroke), the user releases the firing trigger 1004 and aspring (not shown) supported by the handle assembly 5 biases the firingtrigger back 1004 to the staring (unfired position). As the firingtrigger 1004 returns to the starting position, the first clutch plate1052 rotates backwards relative to the second clutch plate 1060 whilethe second clutch plate 1060 remains stationary and does not move. Theuser can then depress the firing trigger 1004 again until the dynamicclamping member 150, knife 155, and sled 160 have been completelyretracted into a starting position within the elongate channel assembly120 by the retract cable 1330.

In an embodiment depicted in FIGS. 18 and 20, the first rotatable spool1250 and the second rotatable spool 1260 are tapered. That is, they havea decreasing diameter along their respective axial directions. Thus, thewinch assembly 1001 has the ability to change the mechanical advantageas it takes up cable. In this embodiment, the advance cable 1302 isattached to spool 1260 and the retract cable 1330 is attached to spool1250 such that the greatest take up force is generated at the beginningof the firing process. If the winch assembly 1001 is turned at aconstant torque, cable is taken up on the spool and the change in thespool's diameter would change the force transmitted to the cable. Sucharrangement is particularly advantageous when the largest frictional orresistive forces that must be overcome during the firing process occurat the beginning of the firing sequence. If, however, the largestfrictional and resistive forces are expected to be encountered towardthe end of the firing process, the cables 1302, 1330 could be attachedto the other ends (the smaller ends) of their respective spools 1260,1250. In still other embodiments, if the largest resistive and frictionforces are encountered midway during the firing process, each of thespools 1250, 1260 may have a central portion that has a larger diameterthan the diameters of the end portions of the spools. Such unique andnovel spool configurations, along with the unique and novel pulleyarrangements describe above, enable the device to be designed to addressdifferent frictional and resistive forces encountered during the firingsequence and represent a vast improvement over prior cable related drivesystems employed in connection with surgical stapling instruments.

While the cable drive system 1000 described above comprises a manuallyactuatable drive system, other contemplated embodiments of the presentinvention may employ a battery powered motor or motors, alternatingcurrent powered motor or motors or pneumatically powered motors to powerthe cable drive systems. Thus, the protection afforded to the variousembodiments of the present invention should not solely be limited tosurgical instruments that are manually actuatable.

FIGS. 15A, 16A, and 21 illustrate another improved firing systemembodiment 1300′ of the present invention. As can be seen in FIGS. 15Aand 16A, this embodiment employs a pair of advance cables 1310′, 1320′and a retract cable 1330. FIGS. 15A and 16A, illustrate the cables1310′, 1320′, and 1330 in diagrammatic form. As can be seen in thoseFigures, a first advance cable 1310′ is operably supported on a firstdistal cable transition support 1340 which may comprise, for example, apulley, rod, capstan, etc. that is attached to the distal end 123 of theelongate channel assembly 120 as was described above and a firstproximal cable transition support 1350 which may comprise, for example,a pulley, rod, capstan, etc. 1350 that is operably supported by theelongate channel assembly 120. A distal end 1312′ of the first advancecable 1310′ is affixed to the knife assembly 170 (dynamic clampingassembly 150) and the proximal end 1314′ of the first advance cable1310′ is attached to a connector 1380 attached to a reciprocatable drivemember 1390. As can be seen in FIGS. 15A and 16A, the first distal cabletransition support 1340 may be oriented such that its axis of rotationis substantially perpendicular to the axis of rotation of the firstproximal cable transition support 1350. The second advance cable 1320′is operably supported on a second distal cable transition support 1360which may, for example, comprise a pulley, rod, capstan etc. that ismounted to the distal end 123 of the elongate channel assembly 120 and asecond proximal cable transition support 1370 which may, for example,comprise a pulley, rod, capstan, etc. mounted to the proximal end of theelongate channel assembly 120. The proximal end 1322′ of the secondadvance cable 1320 may be attached to the knife assembly 170 (dynamicclamping assembly 150) and the proximal end 1324′ may be attached to theconnector 1380′. Also in these embodiments, a retract cable 1330 isemployed. In one embodiment, the retract cable 1300 may be formed in aloop such that the distal looped end 1332 is fixedly attached (swaged,etc.) to the dynamic clamping assembly 150 and the two proximal ends1334, 1336 are each fixedly attached (swaged, etc.) to the connector1380.

Those of ordinary skill in the art will understand that the dynamicclamping assembly 150, knife 155, and sled 160 may be advanced in thedistal direction (“DD”) when the drive rod 1390 is also advanced in thedistal direction “DD”. To retract the knife in the proximal direction“PD”, the drive rod 1390 is moved in the proximal direction “PD”. Invarious embodiments, the drive rod 1390 may be selectively advanced andretracted by a drive system 1400 that is somewhat similar in operationas to the operation of the winch assembly 1001, except for thedifferences discussed below. In particular, as can be seen in FIG. 21, ahandle gear segment 1006 may be formed or otherwise provided on thefiring trigger (not shown). The handle gear segment 1006 may be mountedin meshing engagement with a primary drive gear 1040 that is mounted toa shaft (not shown) attached to a first ratchet clutch plate 1052 of aclutch assembly 1050. A second ratchet clutch plate 1060 is supported ona clutch shaft 1062 that is rotatably supported within the handleassembly 5. The clutch shaft 1062 may be provided with a shoulderportion (not shown) and have a clutch spring 1066 journaled thereon tobias the second ratchet clutch plate 1060 into meshing engagement withthe first ratchet clutch plate 1050.

A second drive gear 1070 may be journaled on the clutch shaft 1062 andis in meshing engagement with a third drive gear 1080 that is attachedto a first transmission shaft 1090 that is rotatably supported by afirst transmission bearing or sleeve (not shown) mounted in the frameassembly 1012′. The first transmission shaft 1090 has a first piniongear portion 1100 and a series of first gear teeth 1102 formed thereonfor selective meshing engagement with a series of primary gear teeth1112 on a an axially and rotatably movable shaft spool 1110. The shaftspool 1110 is received on a splined shaft (not shown) 1120 that isrotatably received within the first transmission shaft 1090 and a secondpinion gear 1130. The second pinion gear 1130 has a second pinion gearportion 1132 and a series of second gear teeth 1134 for selectivemeshing engagement with secondary gear teeth 1114 on the shaft spool1110. The second pinion gear 1130 may be rotatably supported by a secondbearing (not shown) mounted in the frame assembly 1012′ as shown.

A reversing bevel gear 1140 is supported by the frame assembly 1012′ inmeshing engagement with the first and second pinion gears 1100, 1130,respectively. The shaft spool 1110 has a collar portion 1150 formedthereon for receiving two opposing pins 1162 extending from a yoke 1160formed on a bottom portion of a switch bar 1166. The switch bar 1166 hasa shaft portion 1168 that is pivotally pinned to a crossbar portion1014′ of the frame assembly 1012′. A portion of the shaft 1168 protrudesout through an opening in the handle case (not shown) and a switchbutton 1170 may be attached to the end of the shaft 1168 to enable theuser to shift the shaft 1168 axially back and forth to reverse the drive1400 as will be further discussed below. Those of ordinary skill in theart will appreciate that the yoke arrangement 1160 enables the shaftspool 1110 to freely rotate relative to the yoke 1160 while enabling theyoke 1160 to shift the shaft spool 1110 axially on the splined shaft1120.

A shifter output gear 1180 is keyed or otherwise attached to the splinedshaft 20 for rotation therewith. The shifter output gear 1180 isarranged in meshing engagement with a drive gear 1190′ that is attachedto a drive shaft 1200′. Attached to the drive shaft 1200′ is a drivegear 1410 that is in meshing engagement with a rack 1420 that isconstrained to move axially in the distal and proximal directionsbetween two lugs 1422, 1424 formed in the frame 1012′. To affix theproximal end of the drive rod 1390 to the rack 1420, a T-slot 1426 maybe formed in the distal end 1425 of the rack 1420. However, othermethods of attachment may also be employed.

A method of operating the drive system 1400 will now be described. Ascan be seen in FIG. 21, the shaft spool 1110 is in the neutral position.Thus, actuation of the firing trigger 1004 will not result in anymovement of the dynamic clamping member 150, knife 155 or sled 160. Tofire the device (advance the dynamical clamping member 150, knife 155,and sled 160 in the distal direction DD), the clinician shifts theshifter button 1170 such that the first gear teeth 1102 of the firstpinion gear 1100 are brought into meshing engagement with the primarygear teeth 1112 of the shaft spool 1110. After the shaft spool 1110 hasbeen moved to that position, the clinician may begin to pull/pivot thefiring trigger 1004 to cause the handle gear segment 1006 to move. Asthe firing trigger 1004 continues to pivot, the gear segment 1006rotates the primary drive gear of the clutch assembly 1050 and thesecond drive gear 1070. As the second drive gear 1070 rotates in onedirection, the third drive gear 1080 is rotated in the oppositedirection which also causes the first pinion gear 1100 to rotate in thatdirection. Because the first teeth 1102 of the first pinion gear 1100are in meshing engagement with the primary teeth 1112 of the shaft spool1110, the shaft spool 1110 also rotates in that direction. As the shaftspool 1110 rotates in that direction, the splined shaft and the shifteroutput gear 1180 also rotate in that direction. The shifter output gear1180 causes the drive gear 1190′, drive shaft 1200′, and drive gear 1410to rotate in the “B” direction thereby driving the rack in the distaldirection DD.

After the firing trigger 1004 has been depressed as far as it can go (tothe end of its stroke), the clinician releases the firing trigger 1004and a spring (not shown) or other suitable arrangement supported by thehandle assembly 5 biases the firing trigger back 1004 to the staring(unfired position). As the firing trigger 1004 returns to the startingposition, the first clutch plate 1052 rotates backwards (A direction)relative to the second clutch plate 1060 while the second clutch plate1060 remains stationary and does not move. The clinician can thendepress the firing trigger 1004 again until the knife assembly 170(dynamic clamping member 150, knife 155, and sled 160) have beencompletely advanced to the end distal position within the elongatechannel assembly 120 by the rack 1420 and the drive rod 1390.

To retract (move in the proximal direction “PD” to a starting position)the dynamic clamping assembly 150, the knife 155, and the sled 160, theclinician shifts the shifter button 1170 to bring the secondary gearteeth 1114 of the shaft spool 1110 into meshing engagement with thesecond gear teeth 1134 on the second pinion gear 1130. After the shaftspool 1110 has been moved to that position, the clinician may begin topull/pivot the firing trigger 1004 in the manner described above. As thefiring trigger 1004 continues to pivot, the gear segment 1006 rotatesthe primary drive gear 1040 as well as the clutch assembly 1050 and thesecond drive gear 1070 in the “B” direction. As the second drive gear1070 rotates in that direction, the third drive gear 1080 is rotated inthe opposite “A” direction which also causes the first pinion gear 1100to rotate in that direction. As the first pinion gear 1100 rotates, itcauses the reversing bevel gear 1140 to rotate and cause the secondpinion gear 1130 to rotate in the “B” direction. Because the secondaryteeth 1114 of the shaft spool 1110 are in meshing engagement with thesecond teeth 1134 of the second pinion gear 1130, the shaft spool 1110and the splined shaft 1120 rotate in the “B” direction. The shift outputgear 1180 causes the drive gear 1190′, drive shaft 1200′, and drive gear1410 to rotate in the “A” direction which causes the rack 1424 to movein the proximal direction “PD”.

After the firing trigger 1004 has been depressed as far as it can go (tothe end of its stroke), the user releases the firing trigger 1004 and aspring (not shown) supported by the handle assembly 5 biases the firingtrigger 1004 back to the starting (unfired) position. As the firingtrigger 1004 returns to the starting position, the first clutch plate1052 rotates backwards (A direction) relative to the second clutch plate1060 while the second clutch plate 1060 remains stationary and does notmove. The user can then depress the firing trigger 1004 again until thedynamic clamping member 150, knife 155, and sled 160 have beencompletely retracted into a starting position within the elongatechannel assembly 120 by the drive rod 1390 and the rack 1424. Those ofordinary skill in the art will understand that changes in the gearratios—either in the transmission or rack and pinion could be used toattain improved mechanical advantages for driving the knife assembly 170(dynamic clamping assembly 150, knife 155, sled 160) within the elongatechannel assembly 120.

While the cable drive system 1400 described above comprises a manuallyactuatable drive system, other contemplated embodiments of the presentinvention may employ a battery powered motor or motors, alternatingcurrent powered motor or motors or pneumatically powered motors to powerthe cable drive system. Thus, the protection afforded to the variousembodiments of the present invention should not solely be limited tosurgical instruments that are manually actuatable.

FIGS. 22-24 illustrate a portion of another surgical stapling instrument1500 that may employ certain features of the present invention. Thisembodiment employs a hollow spine or tube 1510 that extends from thehandle (not shown) to the channel assembly (not shown). In theembodiment depicted in FIGS. 22-24, the hollow spine 1510 is coupled toan articulation joint 1512 of the type and construction disclosed inU.S. Patent Publication No. US 2005/0006432 to Racenet et al., thedisclosure of which is herein incorporated by reference. Otherarticulation joint arrangements could also be employed without departingfrom the spirit and scope of the present invention. As can be seen inFIGS. 22-24, a drive rod 1520 extends through the hollow tube 1510 andhas a proximal end 1522 that may be coupled to the rack of a drivearrangement of the type described above and supported by the handle. Atransition block 1530 may be attached to or otherwise formed on thedistal end 1524 of the drive rod 1520 for attachment to a driven rod1540. A proximal pulley, rod, capstan, etc. 1560 is mounted within thehollow tube 1510 as shown in FIGS. 22 and 24.

A cable, thread, band, belt, etc. 1570 may be operably supported on oneor more pulleys, rods, capstans, etc. (not shown) formed on the channelassembly (not shown) and extend through the articulation joint 1512 andoperably supported on the distal pulley 1560 as shown in FIGS. 22-24.The cable 1570 may have an advance portion 1572 and a retract portion1574. The end 1576 of the retract portion 1574 may be fixedly attachedto the distal end 1542 of the driven rod 1540 as shown in FIG. 22.Likewise, the other end 1578 of cable 1570 is attached to the distal end1542 of the driven rod 1540. FIG. 22 illustrates the position of thedriven rod 1540 when the dynamic clamping assembly (not shown), knife(not shown), and sled (not shown) are at the distal end of the elongatechannel assembly (not shown). The dynamic clamping assembly, knife, andsled may be moved to a retracted position by operating the drive systemdescribed above (FIG. 21) in the retract mode described above which willcause the drive rod 1520 and the driven rod 1540 to move in the proximaldirection “PD”. The person of ordinary skill in the art will understandthat such arrangement represents a vast improvement in mechanicaladvantage over prior cable arrangements. It will be further appreciatedthat the cable 1570 may flex as the instrument is articulated. In otherembodiments, however, the ends of the cable may be coupled together witha spring coupling arrangement of the type described in further detailbelow.

As was mentioned above, one problem that may be encountered when using acable driven surgical cutting and severing instrument is that the cableor cables may become disengaged from a cable transition support orsupports such as pulleys, rods, capstans, etc. or the like which coulddisable the device. Such cable disengagement may, for example, be causedby mechanical vibration during use of the device or may result fromshock to the device experienced during use or shipping. FIGS. 25-27illustrate other embodiments of the present invention that employ cablestop members 1600 which may, for example, comprise cable retentionblocks 1601 on the elongate channel assembly 120 that are in closeproximity to the cable transition supports 830, 850 to retain the cables800, 820 thereon, respectively. In various embodiments, the cabletransition supports 830, 850 may comprise, for example, pulleys, rods,capstans, etc. Although the cable retention blocks 1610 may be providedin various shapes and configurations, in various embodiments, each cableretention block 1601 may have an arcuate surface 1602 that iscomplementary-shaped relative to the cable 800, 820, such that the cable800, 820 cannot become disengaged from the cable transition support 800,820.

FIGS. 28 and 29 illustrate another cable stop member 1700 which may, forexample, comprise a cable retention block 1701 of other embodiments ofthe present invention. As can be seen in those Figures, the block 1701has a passage 1702 therethrough that forms an arcuate bearing surface1704 over which the cable 800, 820 may pass. In this embodiment, thecable may be threaded into and through the arcuate passage 1702 duringinstallation. Such arrangement avoids the problem of the cable becomingdislodged from a pulley or pulleys, rods, capstans, etc.

FIGS. 30-33 illustrate another embodiment of the present invention indiagrammatic form. This embodiment employs an elongate channel assembly120 that has a dynamic clamping assembly 150, knife 155, and sledassembly 160 (collectively referred to herein as “knife assembly 170”)that is driven by a cable 1800. In particular, the cable 1800 may beoperably supported on a pair of cable transition supports 1802, 1804,which may comprise, for example, pulleys, posts, capstans, etc. mountedto the bottom 128 of the distal end 123 of the elongate channel assembly120 and a third cable transition support 1806 which may comprise, forexample, a pulley, post, capstan, etc. on the knife assembly 170. Inaddition, the cable 1800 may be operably supported on a drive pulley1808 that is movably supported by the handle assembly 5. The drivepulley 1808 may be selectively movable in the distal direction “DD” andthe proximal direction “PD” by a trigger (not shown) or other actuatorarrangement (not shown) in the handle assembly 5.

Other embodiments of the present invention as illustrated in FIGS.30-33, employ a unique and novel cable tensioning joint 1801 forconnecting the ends of the cable 1800 to maintain the tension in thecable 1800 to prevent the cable 1800 from shifting off the pulleys 1802,1804, 1806, 1808. In particular, this arrangement employs a tensioningmember in the form of a spring 1810 that is oriented in a substantiallyparallel path to the cable load path. As can be seen in those Figures, afirst stop member or block 1820 is fixedly attached (swaged, glued,welded, etc.) to a first end 1803 of the cable 1800. The second end 1805of the cable 1800 is also fixedly attached (swaged, welded, glued, etc.)to a second stop member or block 1830. As can be seen in FIG. 33, thesecond stop member 1830 has a passage 1832 therethrough through which aportion of the cable 1800 may slidably pass as represented by the arrowin that Figure. A third stop member or block 1840 is fixedly attached tothe cable 1800 and an end of the spring 1810 is attached thereto. Theother end of the spring 1810 is attached to the second stop member 1830.Those of ordinary skill in the art will understand that such arrangementpermits the cable 1800, when operably supported on cable transitionsupports in the form of, for example, pulleys, capstans, retentionblocks etc., to lengthen a distance “L” (the distance between the firstand second stop members 1820, 1830) when the tension spring 1810 isunexpanded. It will be further appreciated that such arrangement isparticularly advantageous when an articulated instrument is employed asdemonstrated in FIG. 32. In particular, use of the cable tensioningjoint 1801 enables the cable to extend or bend around the articulationjoint while remaining taught about the various cable transitionsupports.

As indicated above, another challenge commonly encountered whenemploying cable driven systems relates to connecting the ends of thecable (drive member) in such a manner as to ensure that the cableeffectively transmits the desired force to the knife/dynamic clampingmember or other surgical instrument component. FIGS. 34 and 35illustrate an endless cable 1900 of various embodiments of the presentinvention. In this embodiment, for example, the endless cable 1900 maycomprise a woven metal wire or woven plastic member. To form the endlesscable, the fibers 1903 of the end 1902 may be interwoven with the fibers1905 of the end 1904 to form a cable loop. Another embodiment is aChinese finger cuff (FIG. 35) approach wherein one end is inserted intothe other end of a hollow woven cable to form a connection that getstighter with tension. In various embodiments, some fasteningagent/adhesive may be employed during assembly to facilitate suchpretentioning of the joint. Such arrangement, for example, may permitthe cable 1900 to somewhat constrict about its longitudinal axis “L-L”when tension is applied in the longitudinal direction. One example ofsuch weave pattern is disclosed in U.S. Pat. No. 4,817,643 to Olsen, thedisclosure of which is herein incorporated by reference. After the ends1902, 1904 are braded together as shown, the cable 1900 forms a closedloop 1906. The cable may be looped around a driven pulley or othermember and a portion of a movable member such as pins, pulleys, capstansor other portions of the surgical instrument components when the ends1902, 1904 are braided or interwoven together.

FIGS. 36-38 illustrate another cable attachment arrangement 2000 of thepresent invention for attaching a cable to a surgical instrumentcomponent. As can be seen in those Figures, the cable 2002 may have asubstantially wedge-shaped or substantially conically shaped slug 2010that has a hole 2012 extending therethrough for receiving an end 2004 ofthe cable 2002 as shown in FIG. 36. The slug 2010 may be crimped,swaged, glued, overmolded, ultrasonically welded, etc. onto the cableend 2012 as shown. In various embodiments, for example, the slug 2010may be fabricated from a somewhat soft material such as lead, copper,brass, stainless steel, titanium, etc. or, for example, a thermoplasticmaterial such as nylon or polycarbonate. The slug 2010 is sized to bereceived in a complementary shaped pocket 2020 in surgical instrumentcomponent to which it is to be attached such as, for example, thedynamic clamping member 150. The pocket 2020 may be sized such that, astension is applied to the cable 2002 in the “T” direction, theconnection gets tighter. That is, as the cable tension increases, theslug 2020 is further compressed on the end 2004 of the cable 2002. Invarious embodiments, the pocket 2020 may be open on at least one sidethereof to permit the slug 2010 to be installed therein.

FIG. 39 illustrates another cable attachment arrangement 2100 of variousembodiments of the present invention. As can be seen in that Figure, theend 2112 of the cable 2110 may be wrapped around a pin 2120 and beattached to the other portion 2114 of the cable 2110 by one or moreclamps 2130 that may be crimped or otherwise cinched thereon to form aloop 2140 for receiving at least a portion of the surgical instrumentcomponent such as, for example, a pulley, pin, capstan, etc.

FIG. 40 illustrates another cable attachment arrangement 2200 of variousembodiments of the present invention. As can be seen in that Figure, theend portion 2212 of the cable 2210 may be wrapped around a pin 2220 andbe melted or glued to another adjacent portion 2214 of the cable 2210 toform a loop 2240 for receiving at least a portion of the surgicalinstrument component such as, for example, a pulley, pin, capstan, etc.

The endocutter disclosed in U.S. Patent Publication No. US2006/0011699A1 employs two cable systems: one for closing the anvil; and one thatpulls the dynamic clamping assembly, knife, and sled to cut tissue andform staples. In one arrangement, a cable is attached to the clampingcollar for pulling the clamping collar distally onto and over camsurface to close the anvil relative to the staple cartridge assembly andcompress the tissue. That closure cable must be threaded back throughthe articulation joint to the handle. When the proximal end of thatcable is pulled, the distal end of the cable, which is attached to theclamping collar, causes the clamping collar to move distally and closethe anvil. Such arrangement, however, suffers from the limited abilityto generate clamping force.

FIG. 41 illustrates an articulation joint 1512 of the type disclosed inthe above-mentioned publication. FIGS. 42 and 43 illustrate thearticulation joint assembly 2302 of a closure tube assembly 2300 ofvarious embodiments of the present invention that may be used inconnection with the articulation joint 1512 and eliminate the use of acable to close the anvil 110. FIG. 44 illustrates the closure tubeassembly 2300 installed over the articulation joint 1512. As will bediscussed in further detail below, in various embodiments, the closuretube assembly 2300 is operably supported adjacent the elongate channelassembly 120 for selectively applying a closing motion to the anvilassembly 110 upon closing contact with the closure tube assembly 2300.

As can be seen in FIG. 42, an embodiment of the closure tube assembly2300 may include a distal closure tube segment 2310 that has proximalend 2312 and a distal end 2314, a central closure tube segment 2320 thathas a distal end 2322 and a proximal end 2324, and a proximal closuretube segment 2330 that has a proximal end 2332 and a distal end 2334.The proximal end 2332 of the proximal closure tube segment 2330 may benon-rotatably coupled to a distal end 2342 of a closure tube segment2340. As can be seen in FIG. 43, the distal end 2342 of the hollowclosure tube segment 2340 may be provided with a notch 2344 therein forreceiving a tab 2336 protruding proximally from the distal end 2334 ofthe proximal closure tube segment 2330. As can also be seen in FIG. 43,the proximal end 2332 may be received within the hollow distal end 2342of the hollow closure tube segment 2340. The proximal closure tubesegment 2330 may be retained in coupling engagement with the closuretube segment 2340 by adhesive, glue, etc. Those of ordinary skill in theart will understand that such unique and novel configuration helps tofacilitate assembly of the device. However, in other embodiments forexample, the proximal closure tube segment 2330 may be integrally formedwith the closure tube segment 2340.

In various embodiments, the closure tube assembly 2300 may furthercomprise a first upper tab 2350 protruding from the distal end 2334 ofthe proximal closure tube segment 2330 and a first lower tab 2352protruding from the distal end 2334 of the proximal closure tube segment2330 in spaced relation to the first upper tab 2350. The first upper tab2350 has a first upper pivot hole 2354 therethrough and the first lowertab 2352 has a first lower pivot hole 2356 therethrough that iscoaxially aligned with the first upper hole 2354 in various embodiments.The proximal end 2324 of the central closure tube segment 2320 has asecond upper tab 2326 protruding therefrom and a second lower tab 2328protruding therefrom in spaced relation to the second upper tab 2326.The second upper tab 2326 has a second upper pivot hole 2327therethrough and the second lower tab 2328 has a second lower pivot hole2329 therethrough that is substantially coaxially aligned with thesecond upper pivot hole 2327.

As can be seen in FIG. 44, the distal end 2322 of the central closuretube segment 2320 has a first lateral tab 2321 and a second lateral tab2323 protruding therefrom. The first lateral tab has a first lateralhole (not shown) therethrough and the second lateral tab 2323 has asecond lateral hole 2325 therethrough that is coaxially aligned with thefirst lateral hole 2325. In addition, the proximal end 2312 of thedistal closure tube segment 2310 has a third lateral tab 2316 protrudingtherefrom and a fourth lateral tab 2318 protruding therefrom in spacedrelation to the third lateral tab 2316. The third lateral tab 2316 has athird lateral pivot hole (not shown) therethrough and the fourth lateraltab 2318 has a fourth lateral pivot hole 2319 therethrough that issubstantially coaxially aligned with the third lateral pivot hole.

In various embodiments, the closure tube joint assembly 2302 furtherincludes an upper double pivot link 2360 that has a first upper pin 2362and a second upper pin 2364 protruding therefrom. The first upper pin2362 is sized to be pivotally received in the first upper pivot hole2354 and the second upper pin 2364 is sized to be pivotally received inthe second upper pivot hole 2327. The upper double pivot link 2360 maybe retained in position between the proximal end 2324 of the centralclosure tube segment 2320 and the distal end 2334 of the proximalclosure tube segment 2330 by the articulation joint assembly 1512. Theclosure tube joint assembly 2300 may further include a lower doublepivot link 2370 that has a first lower pin 2372 and a second lower pin2374 protruding therefrom. See FIG. 43. The first lower pin 2372 issized to be pivotally received within the first lower pivot hole 2356and the second lower pin 2374 is sized to be pivotally received in thesecond lower pivot hole 2329. The lower double pivot link 2370 may beretained in position between the proximal end 2324 of the centralclosure tube segment 2320 and the distal end 2322 of the central closuretube segment 2320 by the articulation joint assembly 1512.

When the upper double pivot link 2360 and the lower double pivot link2370 are attached to the proximal end 2324 of the central closure tubesegment 2320 and the distal end 2334 of the proximal closure tubesegment 2330, the first upper pin 2362 and the first lower pin 2372 arecoaxially aligned along a first pivot axis D-D that, in variousembodiments, may be substantially transverse to an elongated shaft axisC-C that extends through the elongated closure tube assembly 1000. SeeFIG. 43. Likewise, the second upper pivot pin 2364 and the second lowerpivot pin 2374 are coaxially aligned along a second pivot axis E-E. Invarious embodiments, the second pivot axis E-E is substantiallytransverse to the elongated shaft axis C-C and substantially parallel tothe first pivot axis D-D. The reader will appreciate that sucharrangement permits the central closure tube segment 2320 to pivotrelative to the proximal closure tube segment 2330 about pivot axes D-Dand E-E.

In various embodiments, the closure tube joint assembly 2302 may furtherinclude a first lateral double pivot link 2380 that has a first upperpin (not shown) and a second upper pin (not shown) protruding therefrom.The first lateral pin is sized to be pivotally received in the firstlateral pivot hole (not shown) in the first lateral tab 2321 and thesecond lateral pin is sized to be pivotally received in the secondlateral pivot hole (not shown) in the third lateral tab 2316. The firstlateral double pivot link 2380 may be retained in position between theproximal end 2312 of the distal closure tube segment 2310 and the distalend 2322 of the central closure tube segment 2320 by the articulationjoint assembly 1512. The closure tube joint assembly 2300 may furtherinclude a second lateral double pivot link 2390 that has a third lateralpin 2392 and a fourth lateral pin 2394 protruding therefrom. The thirdlateral pin 2392 is sized to be pivotally received within the secondlateral hole 2325 in the second lateral tab 2323 and the fourth lateralpin 2394 is sized to be pivotally received in the fourth lateral pivothole 2319 in the fourth lateral tab 2318. The second lateral doublepivot link 2390 may be retained in position between the proximal end2312 of the distal closure tube segment 2310 and the distal end 2322 ofthe central closure tube segment 2320 by the articulation joint assembly1512.

When the first lateral double pivot link 2380 and the second doublepivot link 2390 are attached to the proximal end 2312 of the distalclosure tube segment 2310 and the distal end 2322 of the central closuretube segment 2320, the first lateral pin and the third lateral pin 2392are coaxially aligned along a third pivot axis F-F that, in variousembodiments, may be substantially transverse or orthogonal to theelongated shaft axis C-C. Likewise, the second lateral pivot pin and thefourth lateral pivot pin 2394 are coaxially aligned along a fourth pivotaxis G-G. In various embodiments, the third pivot axis F-F issubstantially transverse or orthogonal to the elongated shaft axis C-Cand the first axis D-D and the second axis E-E and is substantiallyparallel to the fourth pivot axis G-G. The reader will appreciate thatsuch arrangement permits the distal closure tube segment 2310 to pivotrelative to the central closure tube segment 2320 about pivot axes F-Fand G-G. Thus, such arrangement provides a closure tube assembly thatcan move axially over the joint assembly 1512 and still affordmulti-articulation about four axes.

Those of ordinary skill in the art will understand that, as the closuretube assembly 2300 is moved (pushed) in the distal direction DD, thedistal end 2314 of the distal closure tube segment 2310 applies aclosing motion to the anvil assembly 110 by contacting the cam surface115 of anvil assembly 110 (shown in FIGS. 2, 4 and 7) to close anvilassembly 110 relative to the staple cartridge assembly 200. In variousembodiments, a return mechanism, e.g., a spring, cable system or thelike (not shown), may be employed to return the closure tube assembly2300 to a preclamping orientation which causes the anvil assembly 110 tore-open as the closure tube segment 2310 contacts a reverse cam surface117 on the proximal end of the anvil assembly 110. See FIGS. 2 and 7. Inother embodiments as illustrated in FIG. 45, the anvil assembly 110′ maybe formed with an upstanding actuation tab 111′ that is sized to extendinto a horse-shoe shaped opening 2315 in the distal end 2314 of thedistal closure tube segment 2310. See FIG. 44A. Thus, as the closuretube assembly 2300 is moved in the distal direction DD, the horse-shoeshaped opening 2315 contacts the ramp 115 and forces the anvil assembly110′ to a closed position. When the closure tube assembly 2300 is movedin the proximal direction PD, the horse-shoe shaped opening 2315 pullsthe tab 111′ and causes the anvil assembly 110′ to pivot to an openposition.

One closure tube drive system of the present invention is brieflydepicted in FIG. 46. However, other systems could also be effectivelyemployed without departing from the spirit and scope of the presentinvention. As can be seen in FIG. 46, one form of closure tube drivesystem 2400 includes a yoke 2402 connected to a closure trigger 18. Apivot pin 2404 is inserted through aligned openings in both the closuretrigger 18 and the yoke 2402. The distal end of the yoke 2402 isconnected, via a pin 2406, to a first portion 2408 of a closure bracket2410. The first closure bracket portion 2408 connects to a secondclosure bracket portion 2412. Collectively, the closure bracket 2410defines an opening in which the proximal end 2346 of the closure tubesegment 2340 is seated and held such that longitudinal movement of theclosure bracket 2410 essentially pushes or drives the closure tubesegment 2340 (and ultimately the elongated closure tube assembly 2300)in the distal direction DD.

In operation, when the yoke 2402 rotates due to retraction of theclosure trigger 18, the closure bracket 2410 causes the proximal closuretube segment 2340 to move in the proximal PD direction, which causes thedistal closure tube segment 2310 to move proximately. If the anvilassembly 110′ is employed, the tab 111′ causes the anvil assembly 110′to open when the distal closure tube segment 2310 moves proximately.When the closure trigger 18 is unlocked from the locked position, theproximal closure tube segment 2340 is pushed or otherwise driven in thedistal direction DD, which causes the distal closure tube segment 2310to slide distally. The distal closure tube segment 2310 forces the anvilassembly 110′ closed by driving it distally into ramp 115. Such closuresystem 2400 is further described in commonly owned U.S. patentapplication Ser. No. 11/343,547 entitled “Endoscopic Surgical InstrumentWith a Handle That Can Articulate With Respect to the Shaft” toFrederick E. Shelton, IV, et al., the disclosure of which is herebyincorporated by reference in its entirety. Other closure systems may beemployed, however, to axially move the closure tube assembly 2300 in theproximal and distal directions.

FIGS. 47-50 illustrate another unique and novel closure system 2500 ofvarious embodiments of the present invention. In the embodimentsdepicted in these Figures, a manually actuatable drive system 2600 isemployed. Such a drive system arrangement is disclosed in commonly ownedU.S. patent application Ser. No. 11/475,412, filed Jun. 27, 2006,entitled “Manually Driven Surgical Cutting and Fastening Instrument” toFrederick E. Shelton, et al., the disclosure of which is herebyincorporated by reference in its entirety. Thus, the operation of suchdrive system arrangement will not be discussed in great detail herein.As the present Detailed Description proceeds, the person of ordinaryskill in the art will appreciate, however, that the closure system 2500of the present invention may also be effectively employed in connectionwith surgical stapling instruments that employ a cable or cables todrive the dynamic clamping member, knife and sled. In addition, theclosure system 2500 may also be effectively employed in connection withother surgical stapling instruments that employ a motor to drive thedynamic clamping member, knife, sled, etc. Thus, the protection affordedto the closure system 2500 as described herein should not be limited touse only in connection with the manually actuatable drive systemdepicted in the present FIGS. 47-50.

As shown in these Figures, a firing trigger 2610 is operably supportedby the handle assembly 5 and has a series of gear teeth 2612 thereonthat meshingly interface with the drive gear arrangement (not shown)that operably interfaces with a rotary drive shaft 2614. The rotarydrive shaft 2614 may be rotatably supported within a spine 2616 thatextends through an elongate hollow closure tube 2510. The rotary driveshaft 2614 may interface with other drive components operably supportedby the spine 2616 to convey a rotary driving motion to the tool assembly100′. Also in various embodiments, a shifter assembly 2620 interfaceswith the drive gear arrangement. The shifter assembly may include aselector switch 2622 such that when the switch is in one position andthe firing trigger 2610 is pivoted in a ratcheting motion, the rotarydrive shaft 2614 rotates in a first direction to ultimately impart arotary motion to the tool assembly 100′ to cause the dynamic clampingmember or knife assembly to move in a distal DD direction and, when theselector switch 2622 is moved to a second position, ratcheting of thefiring trigger 2610 causes the rotary drive shaft 2614 to rotate in anopposite direction to thereby impart an opposite rotary motion to thetool assembly 100′ and cause the dynamic clamping assembly or knifeassembly to move in the proximal PD direction.

As can also be seen in these Figures, the closure tube assembly 2500 mayfurther include a closure knob 2520 and a rotation assembly 2550 forrotation of the tool assembly. As can be most particularly seen in FIG.48, the closure knob 2520 may be supported on the proximal end 2512 ofthe closure tube 2510 and a spine attachment tube 2618. For assemblypurposes, the closure knob 2520 may be provided in half sections thatare interconnected by mechanical fasteners or adhesive. In oneembodiment, the spine attachment tube 2618 is hollow and has a flangedproximal end 2619. The flanged end 2619 is rotatably supported in aradial slot 2522 provided in the closure knob 2520 such that the closureknob 2520 can freely rotate about the spine attachment tube 2618. As canalso be seen in FIG. 48, the spine 2616 may have a proximal end 2617sized to extend into the spine attachment tube 2618. However, otherarrangements may be employed. As can also be seen in FIG. 48, theproximal end 2512 of the closure tube 2510 may be flanged and orientedto be non-rotatably retained within a second radial slot 2524 formed inthe closure knob 2520 such that rotation of the closure knob 2520 causesthe rotation of the closure tube 2510.

Various embodiments may also include a rotation assembly 2550. As can beseen in FIGS. 47, 49, and 50, the rotation assembly 2550 may include arotation knob 2552 that is rotatably received on the handle assembly 5.As with the closure knob 2520 and housing assembly 5, the rotation knob2552 may be provided in two segments that may be interconnected bymechanical fasteners—screws, snaps, etc. or adhesive for assemblypurposes. In various embodiments, the distal end 2554 of the rotationknob 2552 has a hole 2556 therethrough that is adapted to receivetherein a spline tube 2560 that has a splined section 2562 that is inaxial engagement with the distal end 2554 of the rotation knob 2552 suchthat the rotation knob 2550 may be moved axially relative to the splinetube 2560, but always be engaged with the splined section 2562 thereof.As can be seen in FIG. 48, the spline tube 2560 has a distal end 2564that extends into the closure knob 2520 and is non-rotatably attached tothe spine attachment tube 2618. by adhesive or other suitable fastenerarrangement. A proximal end 2566 of the spline tube 2560 is flanged andis adapted to be received in an annular slot 2570 provided in the handleassembly 5 such that the flanged end 2566 can rotate therein.

As can also be seen in FIGS. 47 and 49, the distal end 2580 of thehousing assembly is flanged and has a first radial gear 2582 formedthereon. The flanged end 2580 of the housing assembly extends into anannular cavity 2567 formed in the rotation knob 2552. The annular cavity2567 is formed by an inwardly extending annular flange 2568 that has asecond radial gear 2569 formed thereon for selective meshing engagementwith the first radial gear 2582. The annular flange 2568 also extendsinto an annular spring cavity 2584 formed in the housing assembly 5. Alocking spring 2590 is provided in the spring cavity 2584 to bias thesecond radial gear 2569 into meshing engagement with the first radialgear 2582. As will be discussed in further detail below, the cliniciancan unlock the spine 2616 thereby enabling the clinician to rotate thespine 2616 and ultimately the tool assembly 100′ to position the toolassembly 100′ in a desired orientation by pulling the rotation knob 2552proximally to disengage the second radial gear 2569 from the firstradial gear 2582 to enable the rotation knob 2550, spline tube 2560 andspine 2616 to rotate.

As shown in FIGS. 47 and 48, the distal end 2514 of the closure tube2510 may be formed with a reduced diameter portion 2515 for slidablyreceiving a nonrotatable closure ring 2594 thereon. In variousembodiments, a pair of slots 2516 are provided therein that are orientedto receive corresponding pins 2596 that protrude inward from the wall ofthe closure ring 2594. In various embodiments, at least one pin and slotarrangement is employed. In alternative embodiments, the pins 2596 maybe in the closure tube 2510 and the slots 2516 may be provided in theclosure ring. FIG. 50 illustrates the anvil 110′ of the tool assembly100′ in an open position. To close the anvil 110′, the clinician simplyrotates the closure knob 2520 in a first direction which also rotatesthe closure tube 2510 in that direction. The rotation of the closuretube 2510, by virtue of the interaction between the pins 2596 and slots2516, causes the closure ring 2594 to move distally into contact with aportion of the anvil 110′ to pivot the anvil 110′ to the closed positiondepicted in FIGS. 47 and 48. As shown in FIG. 48, there is a distance2599 between the proximal end 2598 of the closure ring 2594 and theledge 2517 of the reduced diameter portion 2515 of the closure tube2510. Such distance 2599 represents the amount of axial travel that isavailable to the closure ring 2594. The person of ordinary skill in theart will appreciate that by providing the slots 2516 at relatively lowangles, the pins 2596 will tend to remain in that position and therebyalso retain the anvil 110′ in the closed position. However, otherlocking arrangements may be employed.

To open the anvil 110′, the clinician again moves the brake knob 2552 inthe proximal direction PD and then rotates the closure knob 2520 (andclosure tube 2510) in a second direction as shown in FIGS. 49 and 50. Invarious embodiments, the tissue that was clamped in the tool assembly100′ causes the anvil 110′ to move to the open position. In otherembodiments, a spring or other biasing member (not shown) may beemployed to bias the anvil 110′ to the open position when the closurering 2594 has been moved to the position depicted in FIGS. 49 and 50. Inother embodiments, the closure ring 2594 may be provided with thehorse-shoe shaped opening described above and the anvil 110′ may beconfigured with a tab 111′ as shown in FIG. 45. Thus, in thatembodiment, when the closure ring 2594 is drawn proximally, it pulls theanvil 110′ to the open position. Once in the open position, theclinician may release the brake knob 2552 and the brake 2550 will lockthe closure tube 2510 (and anvil 110′) in the open position. The personof ordinary skill in the art will appreciate that the closure system2500 may also be effectively employed in connection with the closuretube joint assembly 2302 described above. In such arrangement, the slots2516 may be provided in the distal closure tube segment 2310. Sucharrangement would be operated in the same manner as described above,however, the instrument would also be articulatable about multiple axes.

FIG. 51 illustrates another embodiment of the present invention whereinthe distal end 2515′ of the closure tube 2510 has threads 2513 thereonfor threaded engagement with threads 2597 on the closure ring 2594′. Inthis embodiment, the closure ring 2594′ may be configured to interactwith the channel assembly 120 and or spine 2616 such that the closurering 2594′ can move axially relative thereto, but does not rotate. Thethreads 2597 are formed in the proximal end 2595 of the closure ring2594′ such that as the closure tube 2510 is rotated in one direction,the closure ring 2594′ is axially moved in the distal direction DD tocontact the anvil 110′ and pivot the anvil 110′ to the clamped position.Rotation of the closure ring 2594′ in the opposite direction causes theclosure ring 2594′ to move in the proximal direction PD to enable theanvil 110′ to be pivoted open by the tissue that was clamped therein, orby springs or other biasing members. Such use of multiple turn threadsmay provide more closure power than other closure ring arrangements. Inalternative embodiments, the closure ring 2594′ may be provided with thehorse-shoe shaped opening to interact with a closure tab on the anvil.See FIG. 45. The rotation and locking of the closure tube 2510′ may becontrolled by the closure system 2500 and closure tube brake assembly2550 as was described above. This embodiment may also be used inconnection with the various articulation joints described above withoutdeparting from the spirit and scope of the present invention. It will befurther appreciated that such embodiment may be effectively used withthe manual drive system depicted in FIGS. 47 and 49 or with other drivearrangements, such as cable drive arrangements, etc.

FIGS. 52-54 illustrate another cable-actuated closure system 2700embodiment of the present invention. As can be seen in those Figures,various embodiments may include a proximal cover tube 2710 that axiallysupported a proximal spine segment 2720. The proximal spine segment 2720extends from the handle assembly (not shown) and may be supportedthereby in any one of a number of known arrangements without departingfrom the spirit and scope of the present invention.

In various embodiments, the proximal spine segment 2720 has a distal end2722 that has a neck portion 2724 protruding therefrom that has aball-shaped member 2730 attached thereto or otherwise formed therewith.As can also be seen in these Figures, the ball-shaped member 2730 issized to be received in a socket 2750 formed in a proximal end 2742 of achannel-shaped distal spine segment 2740. The ball-shaped member 2730and socket 2750 collectively form a ball joint, generally designated as2760, that affords the distal spine segment 2740 the ability toarticulate in multiple directions relative to the proximal spine segment2720. A sufficient amount of clearance 2748 is provided between theproximal end 2742 of the distal spine segment 2740 and the distal end2722 of the proximal spine segment 2720 to enable the distal spinesegment to articulate in a desired range of motion relative to theproximal spine segment 2720. In various embodiments, the distal spinesegment 2740 is attached to the elongate channel assembly 120″ to whichthe anvil 110″ is pivotally attached. As can be further seen in FIGS.52-54, a closure ring 2770 is supported on the distal spine segment 2740for selective axial travel thereon.

In various embodiments, the opening and closing of the anvil 110′ may beaccomplished by a closure cable 2780 that extends from the handleassembly (not shown) through a hollow passage 2726 in the proximal spinesegment 2720 and neck portion 2724. The proximal end (not shown) of theclosure cable 2780 may be attached to one of the cable drive systemsdescribed herein or other cable control systems for selectively applyingtension to the cable 2780. Those of ordinary skill in the art willfurther appreciate that a drive cable system of the various typesdescribed above may also be employed to drive the dynamic clampingmember, knife, and sled.

As can be seen in FIGS. 52-54, the closure ring 2770 may have a firstcable transition support 2790 mounted thereon that extends into the openupper end of the channel-shaped distal spine segment 2740 such that thefirst cable transition support 2790 can move distally and axially backand forth within the distal spine segment 2740 as the closure ring 2770moves thereon. In various embodiments, the first cable transitionsupport 2790 may comprise a support selected from the group of supportsconsisting of pulleys, rod, capstans, etc. In addition, a second cabletransition support 2792 may be mounted within the distal spine segment2740 in the orientation shown such that the closure cable 2780 may beoperably supported on the first and second cable transition supports2790, 2792. Similarly, the second cable transition support 2792 maycomprise a cable transition support selected from the group oftransition supports consisting of pulleys, rods, capstans, etc.

The distal end 2782 of the closure cable 2780 may be fixed to the distalspine segment 2740 at a point of attachment 2744. Thus, applying tensionto the closure cable 2780 (pulling the closure cable 2780 in theproximal direction PD) causes the closure ring 2770 to move in thedistal direction DD to contact the anvil 110′ and pivot it to a closedposition in the manner discussed above. In various embodiments, thetissue that was clamped in the tool assembly 100″ causes the anvil 110′to move to the open position. In other embodiments, a spring or otherbiasing member (not shown) may be employed to bias the anvil 110′ to theopen position when the closure ring 2770 has been axially moved to itsproximal unclamped position. Such unique and novel cable actuatedclosure system enjoys a significant mechanical advantage improvementover prior cable powered closure systems while also providing theability to articulate the tool assembly 100″ relative to the otherportion of the instrument. Other embodiments are also contemplatedwherein the ball-shaped member is formed in the distal spine segment2740 and the socket is formed in the proximal spine segment 2720. Instill other embodiments, no articulation joint is employed. That is, theproximal spine segment and distal spine segment comprise a singlemember.

FIGS. 55-57 illustrate a cable controlled lockable articulation joint2800 of various embodiments of the present invention that interfacesbetween the elongate channel assembly 120″ and a proximal spine segment2820. In various embodiments, the proximal spine segment 2820 may extendfrom the handle assembly (not shown) and may be supported thereby in anyone of a number of known arrangements without departing from the spiritand scope of the present invention. The proximal spine segment 2780 mayhave a distal end 2822 that has a neck portion 2824 protruding therefromthat has a substantially ball-shaped member 2830 attached thereto orotherwise formed therewith. As can also be seen in these Figures, theball-shaped member 2830 may be sized to be received in a socket 2850formed in a proximal end 2842 of a distal spine segment 2840. Theball-shaped member 2830 and socket 2850 collectively form a ball joint,generally designated as 2800, that affords the distal spine segment 2840with the ability to articulate in multiple directions relative to theproximal spine segment 2820. A sufficient amount of clearance 2848 maybe provided between the proximal end 2842 of the distal spine segment2840 and the distal end 2822 of the proximal spine segment 2820 toenable the distal spine segment 2840 to articulate in a desired range ofmotion relative to the proximal spine segment 2820. In variousembodiments, the distal spine segment 2840 may be attached to thechannel assembly 120″ to which the anvil (not shown) is pivotallyattached.

In various embodiments, one or more radially extendable portions 2880may be provided in the ball-shaped member 2830. In the embodimentdepicted in FIGS. 55-57, three radially extendable fingers 2880 areprovided, for example. In various embodiments, the radially extendablefingers 2880 may be equally spaced about the ball-shaped member 2830(e.g., spaced at 120° intervals). Other numbers of radially extendablefingers 2880 could also be successfully employed. In variousembodiments, the ball-shaped member 2830 may be fabricated from, forexample, plastic, metal, etc. such that the radially extendable fingersmay be pulled or otherwise driven radially outward a distance to lockthe ball-shaped member 2830 in a desired orientation within the socket2850.

In various embodiments, each of the radially extendable fingers 2880 mayhave a cable 2882 attached thereto that extend adjacent the neck portion2824 of the proximal spine segment 2820 and through correspondingpassages 2826 in the distal end 2822 of the proximal spine segment 2820.The cables 2882 may extend through the hollow proximal spine segment2820 to a control system supported by the handle (not shown) toselectively apply a tension force to the cables 2882. For example, thecables 2882 may be associated with a locking trigger or other mechanismsupported in the handle that can be moved to apply a tension to thecables and be selectively retained in that position until it is desiredto release the joint whereby the mechanism may be unlocked to releasethe tension in the cables 2882. As can be seen in FIG. 55, a hollowcable ring 2890 may be employed as shown to retain the cables 2882adjacent the neck portion 2824.

To use this embodiment, the clinician positions the tool assembly 100 inthe patient and then applies an articulation force to the tool assemblywith another surgical instrument or by bringing the tool assembly 100into contact with a portion of the patient to articulate the toolassembly to a desired position before applying tension to the lockingcables 2882. After the tool assembly 100 has been articulated to thedesired position, the clinician applies a tension force to the lockingcables 2882 which causes the radially extendable fingers 2880 to extendradially outward and lock the ball-shaped member 2830 in thatorientation within the socket 2850 to thereby retain the distal spinesegment 2840 (and the tool assembly 100 attached thereto) in thatarticulated position. Such system employs a “passive” articulationtechnique.

FIGS. 58-61 illustrate another cable controlled lockable articulationjoint 2900 of various embodiments of the present invention. As can beseen in those Figures, various embodiments may include a proximal spinesegment 2920 that extends from the handle assembly (not shown) and maybe supported thereby in any one of a number of known arrangementswithout departing from the spirit and scope of the present invention. Ascan also be seen in FIG. 58, a ball-shaped member 2936 may be formed ona proximal end 2932 of a distal spine segment 2930. The ball-shapedmember 2936 may be sized to be received in a socket 2924 formed in thedistal end 2922 of the proximal spine segment 2920. The ball-shapedmember 2936 and socket 2924 collectively form a ball joint, generallydesignated as 2910, that affords the distal spine segment 2930 with theability to articulate in multiple directions relative to the proximalspine segment 2920. A sufficient amount of clearance 2948 is providedbetween the proximal end 2932 of the distal spine segment 2930 and thedistal end 2922 of the proximal spine segment 2920 to enable the distalspine segment 2930 to articulate in a desired range of motion relativeto the proximal spine segment 2920. In various embodiments, the distalspine segment 2930 may be attached to the channel assembly (not shown)to which the anvil (not shown) is pivotally attached.

In various embodiments, the distal end 2922 of the proximal spinesegment 2920 may have a flexible section 2950 and a cincture section2960. The proximal spine section may be fabricated from, for example,plastic, metal, etc. The flexible section 2950 may be defined by aseries of equally spaced slots 2952 provided into the distal end 2922 ofthe proximal spine segment 2920 to form a plurality of radiallycontractable locking portions in the form of, for example, flexiblesegments 2954 that serve to define the socket 2924 therebetween. Inaddition, a circumferentially extending groove 2956 may be providedaround the circumference of the distal end 2922 of the proximal spinesegment 2920. A locking cable 2970 may extend through the hollowproximal spine segment 2920 and be looped around the cincture section2960 in the circumferentially extending groove 2956 as shown in FIGS. 59and 61. As can be seen in those Figures, the cable 2970 may pass throughtwo passages 2957, 2958 such that the ends thereof may extend throughthe proximal spine section 2920 to a cable control system (not shown)supported in the handle assembly (not shown) that may be used toselectively apply a tension force to the cable 2970.

To use this embodiment, the clinician positions the tool assembly 100 inthe patient and then applies an articulation force to the tool assemblywith another surgical instrument or by bringing the tool assembly 100into contact with a portion of the patient to articulate the toolassembly to a desired position before applying tension to the lockingcable 2970. After the tool assembly 100 has been articulated to thedesired position, the clinician applies tension to the locking cables2970 which causes the flexible segments 2954 to lock around theball-shaped member 2936 and prevent it from moving relative to theproximal spine segment 2920 to thereby retain the distal spine segment2840 (and the tool assembly 100 attached thereto) in that articulatedposition. Such system employs a “passive” articulation technique. Torelease the ball-shaped member to permit further articulation of thetool assembly, the tension is released from the cable 2970.

FIGS. 62-64 illustrate another lockable articulation joint 3000 ofvarious embodiments of the present invention. As can be seen in thoseFigures, various embodiments may include a proximal spine segment 3010that extends from the handle assembly (not shown) and may be supportedthereby in any one of a number of known arrangements without departingfrom the spirit and scope of the present invention. The proximal spinesegment 3010 has a distal end 3012 that has a neck portion 3014protruding therefrom that has a substantially ball-shaped member 3016formed thereon. As can be seen in FIGS. 63 and 64, the ball-shapedmember 3016 has a series of slots 3018 therein that serve to define aseries of ball segments 3020. As shown in FIG. 62, the ball-shapedmember 3016 may be sized to be received in a socket 3034 formed in aproximal end 3032 of a distal spine segment 3030. The ball-shaped member3016 and socket 3034 collectively form a ball joint, generallydesignated as 3040 that affords the distal spine segment 3030 with theability to articulate in multiple directions relative to the proximalspine segment 3010. A sufficient amount of clearance 3042 may beprovided between the proximal end 3032 of the distal spine segment 3030and the distal end 3012 of the proximal spine segment 3010 to enable thedistal spine segment 3030 to articulate in a desired range of motionrelative to the proximal spine segment 3010. In various embodiments, thedistal spine segment 3030 may be attached to the channel assembly (notshown) to which the anvil (not shown) is pivotally attached.

As can be seen in FIG. 62, an actuation member 3050 may be used toselectively radially extend the ball segments 3020 to expand and lockthe ball-shaped member 3016 in the socket 3034. In one embodiment (FIGS.62-64), the actuation member has a hollow shaft portion 3052 thatextends through a passage 3015 in the neck portion 3014 of the proximalspine segment 3010 and also through a passage 3017 in the ball-shapedmember 3016. The distal end 3054 of the actuation member 3050 has asubstantially cone-shaped portion 3056 that is received in a cone-shapedactuation pocket 3018 in the ball-shaped member 3016 as shown. As theactuation member 3050 is drawn in the proximal direction PD, thecone-shaped portion 3056 causes the ball segments 3020 to extendradially outward and lock the ball-shaped member 3016 within the socket3034. Various trigger and locking arrangements (not shown) in the handlemay be employed to selectively axially move the actuation member in theproximal PD and distal DD directions and lock the actuation member 3050in position to retain the ball-shaped member 3016 in an expanded/lockedcondition.

To use this embodiment, the clinician positions the tool assembly 100 inthe patient and then applies an articulation force to the tool assemblywith another surgical instrument or by bringing the tool assembly 100into contact with a portion of the patient to articulate the toolassembly to a desired position before drawing the actuation member 3050in the proximal direction PD. After the tool assembly 100 has beenarticulated to the desired position, the clinician draws the actuationmember 3050 in the proximal direction to cause the ball segments 3020 toexpand radially outwardly and lock the ball-shaped member 3016 in thatorientation within the socket 3034 to thereby retain the distal spinesegment 3030 (and the tool assembly 100 attached thereto) in thatarticulated position. Such system employs a “passive” articulationtechnique.

FIGS. 65-67 depict another lockable articulation joint 3100 of variousembodiments of the present invention that is substantially identical inoperation as articulation joint 3000 described above, except for theactuation member 3150 and the ball-shaped member 3116. As can be seen inthose Figures, the ball-shaped member 3116 has at least one andpreferably three radially extendable portions 3120 formed therein. Theactuation member 3150 has a hollow shaft portion 3152 that extendsthrough a passage 3015 in the neck portion 3014 of the proximal spinesegment 3010 and also through a passage 3017 in the ball-shaped member3116. The distal end 3154 of the actuation member 3150 has a cone-shapedwedge portion 3156 that corresponds to each of the radially extendableportions 3120 in the ball-shaped member 3116 that extends into acone-shaped actuation pocket 3118 in the ball-shaped member 3116 asshown. As the actuation member 3150 is drawn in the proximal directionPD, the cone-shaped wedge portions 3156 causes the correspondingradially extendable portions 3120 to expand radially outward and lockthe ball-shaped member 3116 within the socket 3034. Various trigger andlocking arrangements (not shown) in the handle may be employed toselectively move the actuation member in the proximal PD and distal DDdirections and lock the member in position to retain the ball-shapedmember 3116 in a expanded/locked condition.

To use this embodiment, the clinician positions the tool assembly 100 inthe patient and then applies an articulation force to the tool assemblywith another surgical instrument or by bringing the tool assembly 100into contact with a portion of the patient to articulate the toolassembly to a desired position before drawing the actuation member 3150in the proximal direction PD. After the tool assembly 100 has beenarticulated to the desired position, the clinician draws the actuationmember 3150 in the proximal direction to cause the radially extendableportions 3120 to extend radially outwardly and lock the ball-shapedmember 3116 in that orientation within the socket 3034 to thereby retainthe distal spine segment 3030 (and the tool assembly 100 attachedthereto) in that articulated position. Such system employs a “passive”articulation technique.

FIGS. 68-70 illustrate another lockable articulation joint 3200 ofvarious embodiments of the present invention. As can be seen in thoseFigures, various embodiments may include a proximal spine segment 3210that extends from the handle assembly (not shown) and may be supportedthereby in any one of a number of known arrangements without departingfrom the spirit and scope of the present invention. The proximal spinesegment 3210 may have a distal end 3012 that has a plurality of radiallycontractable portions in the form of, for example, flexible socketfingers 3214 that define a socket 3216 therein. As can also be seen inthese FIG. 68, a ball-shaped member 3310 may be formed on a proximal end3312 of a distal spine segment 3300. The ball-shaped member 3310 may beformed on the end of a neck portion 3308 sized to be received in asocket 3216 formed by the socket fingers 3214. The ball-shaped member3310 and socket 3216 collectively form a ball joint, generallydesignated as 3320, that affords the distal spine segment 3300 with theability to articulate in multiple directions relative to the proximalspine segment 3210. A sufficient amount of clearance 3002 may beprovided between the proximal end 3304 of the distal spine segment 3300and the distal end 3212 of the proximal spine segment 3210 to enable thedistal spine segment 3300 to articulate in a desired range of motionrelative to the proximal spine segment 3210. In various embodiments, thedistal spine segment 3300 may be attached to the channel assembly (notshown) to which the anvil (not shown) is pivotally attached. Inaddition, a hollow passage 3306 may be provided through the ball-shapedmember 3310 and a neck portion 3308 to facilitate passage of cables orother actuation instruments/components therethrough.

As can also be seen in FIGS. 68-70, this embodiment may also include aclosure ring 3400 that is selectively slidably and axially movable onthe proximal spine segment 3210 in the proximal and distal directions.The various systems and components described above may be employed toselectively move the closure ring 3400 in the distal and proximaldirections. As can be most particularly seen in FIG. 68, the socketfingers 3214 have a sloped or tapered end surface 3215 to enable thedistal end portion 3402 of the closure ring 3400 to slide thereupon andcause the closure fingers to 3214 to close upon the ball-shaped member3310 and lock it in position.

To use this embodiment, the clinician positions the tool assembly 100 inthe patient and then applies an articulation force to the tool assemblywith another surgical instrument or by bringing the tool assembly 100into contact with a portion of the patient to articulate the toolassembly to a desired position before advancing the closure ring 3400distally. After the tool assembly 100 has been articulated to thedesired position, the clinician advances the closure ring 3400 distallyto cause the closure fingers 3214 to closure upon the ball-shaped member3310 and lock the ball-shaped member 3310 in that orientation within thesocket 3216 to thereby retain the distal spine segment 3300 (and thetool assembly 100 attached thereto) in that articulated position. Suchsystem employs a “passive” articulation technique.

FIG. 71 illustrates another passive articulation joint 3500 of variousembodiments of the present invention. As can be seen in those Figures,various embodiments may include a proximal spine segment 3510 thatextends from the handle assembly (not shown) and may be supportedthereby in any one of a number of known arrangements without departingfrom the spirit and scope of the present invention. The proximal spinesegment 3510 may have a distal end 3512 that has a socket 3514 therein.As can also be seen in FIG. 71, a ball-shaped member 3530 is formed on aneck portion 3532 formed on the proximal end 3522 of a distal spinesegment 3520. The ball-shaped member 3530 and socket 3514 collectivelyform a ball joint, generally designated as 3540, that affords the distalspine segment 3520 with the ability to articulate in multiple directionsrelative to the proximal spine segment 3510. In alternative embodiments,the socket may be formed in the distal spine segment and the ball-shapedmember may be formed in the proximal spine segment. A sufficient amountof clearance 3542 may be provided between the proximal end 3522 of thedistal spine segment 3520 and the distal end 3512 of the proximal spinesegment 3510 to enable the distal spine segment 3520 to articulate in adesired range of motion relative to the proximal spine segment 3510. Invarious embodiments, the distal spine segment 3520 is attached to thechannel assembly (not shown) to which the anvil (not shown) is pivotallyattached.

As can be further seen in FIG. 71, the proximal facing face 3532 of theball-shaped member 3530 has a plurality of detents 3534 formed therein.A locking pin 3550 is operably supported within the proximal spinesegment 3510 and is oriented for engagement with the detents 3534. Thelocking pin 3550 may be spring biased toward the proximal facing face3532 of the ball-shaped member 3530 such that as the distal spinesegment 3520 is articulated relative to the proximal spine segment 3510,the locking pin snaps into a corresponding one of the detents 3534 toretain the distal spine segment 3520 in that position.

To use this embodiment, the clinician positions the tool assembly 100 inthe patient and then applies an articulation force to the tool assemblywith another surgical instrument or by bringing the tool assembly 100into contact with a portion of the patient to articulate the toolassembly to a desired position or another surgical tool may be used toapply an articulation force to the tool assembly to cause the toolassembly 100 to move to a desired direction. As the tool assembly isarticulated, the distal end 3552 of the locking pin will snap into andout of detents 3534 until the desired articulation position is achieved.Such system employs a “passive” articulation technique.

FIG. 72 illustrates another passive articulation joint 3600 of variousembodiments of the present invention that is somewhat similar to thearticulation joint 3500 described above except for the differencesdiscussed below. In this embodiment for example, the ball-shaped member3630 may be formed on a neck portion 3632 that protrudes distally fromthe proximal spine segment 3610. The proximal spine segment 3610 mayextend from the handle assembly (not shown) and may be supported therebyin any one of a number of known arrangements without departing from thespirit and scope of the present invention. The distal spine segment 3620has a socket 3624 therein. The ball-shaped member 3630 and socket 3622collectively form a ball joint, generally designated as 3650 thataffords the distal spine segment 3620 the ability to articulate inmultiple directions relative to the proximal spine segment 3610. Asufficient amount of clearance 3642 is provided between the proximal end3622 of the distal spine segment 3620 and the distal end 3612 of theproximal spine segment 3610 to enable the distal spine segment 3620 toarticulate in a desired range of motion relative to the proximal spinesegment 3610. In various embodiments, the distal spine segment 3620 isattached to the channel assembly (not shown) to which the anvil (notshown) is pivotally attached.

As can be further seen in FIG. 72, a portion 3638 of the socket face3636 may have a plurality of detents 3639 formed therein. A locking pin3660 is operably supported within the proximal spine segment 3610 and isoriented for engagement with the detents 3639. The locking pin 3660 maybe spring biased toward the face 3636 such that as the distal spinesegment 3620 is articulated relative to the proximal spine segment 3610,the locking pin 3660 snaps into a corresponding one of the detents 3639to retain the distal spine segment 3620 in that position.

To use this embodiment, the clinician positions the tool assembly 100 inthe patient and then applies an articulation force to the tool assemblywith another surgical instrument or by bringing the tool assembly 100into contact with a portion of the patient to articulate the toolassembly to a desired position or another surgical tool may be used toapply an articulation force to the tool assembly to cause the toolassembly 100 to move to a desired direction. As the tool assembly isarticulated, the distal end 3662 of the locking pin 3660 will snap intoand out of detents 3639 until the desired articulation position isachieved. Such system employs a “passive” articulation technique.

Various surgical stapling instrument embodiments of the presentinvention may be designed to accommodate tool assemblies that aredesigned to be discarded after a single use. After the staplingoperation is completed, the tool assembly is discarded and theinstrument may be re-sterilized in preparation for another operation. Insuch applications, it is often desirable, therefore, to employ a jointarrangement that facilitates quick attachment and detachment of the toolassembly to the instrument. FIGS. 73-83 illustrate a surgical instrument4000 that is constructed for use in connection a surgical tool assembly100″ that can perform a surgical action. In various embodiments, thetool assembly 100″ is constructed to cut and staple tissue my means ofthe cable-powered dynamic clamping member/knife arrangement describedabove. In other embodiments, different drive arrangements may beemployed to drive the dynamic clamping member/knife through the elongatechannel portion of the tool assembly 100″.

In some embodiments, the tool assembly 100″ comprises a portion of adisposable reload unit 4002. In other embodiments, the tool assembly100″ may be permanently attached to the other portions of the instrument4000 and capable of reuse in connection with staple cartridgeassemblies. The disposable reload unit 4002 may further include aconnector segment 4004 for coupling the disposable reload unit 4002 tothe instrument 4000. In various embodiments, the tool assembly 100″ maybe articulatable relative to the connector portion 4004 by means of anarticulation joint 4006.

As can be most particularly see in FIG. 73A, one tool assembly 100″embodiment may include an elongate channel assembly 4012 that has ananvil assembly 4020 pivotally coupled thereto. For example, in oneembodiment, the anvil assembly 4020 may have a pair of trunnions 4022that are adapted to be received in corresponding slots 4014 in the wallsof the elongate channel assembly 4012 as shown. The anvil assembly 4020may be formed with an anvil closure tab 4026 on a proximal end 4024thereof for selective contact by a closure ring 4030. The non-rotatingclosure ring 4030 is keyed to the elongate channel assembly 4012 and/oranvil assembly 4020 such that the closure ring 4030 cannot rotaterelative to the elongate channel 4012. A tab clearance opening 4032 maybe provided through the closure ring 4030 to receive the anvil closuretab 4026 when the anvil assembly 4020 is in the closed (clamped)position. A series of internal threads 4036 may be provided in theproximal end 4034 of the non-rotating closure ring 4030 for threadablyreceiving a threaded distal end 4042 of a distal closure tube segment4040. As will be discussed in further detail below, as the distalclosure tube segment 4040 is rotated, the closure ring 4030 is drivenaxially in the distal direction DD. As the closure ring 4030 moves inthe distal direction DD, it rides up a ramp 4021 on the proximal end ofanvil assembly 4020 to cause the anvil assembly 4020 to pivot to aclosed position. Such arrangement represents a vast improvement overprior arrangements wherein the closure ring is pulled by a cable in thedistal direction.

The surgical instrument 4000 may further include an elongate closuretube assembly 5000 that houses a variety of components and which isoperably attached to a handle assembly as will be discussed in furtherdetail below. In various embodiments of the present invention, theclosure tube assembly 5000 may comprise an intermediate closure tubesegment 5001 and a proximal closure tube segment 5020. In someembodiments, the tool assembly 100″ may be coupled to the intermediateclosure tube segment 5001 of closure tube assembly 5000 by anarticulation joint 4006 that facilitates travel of the tool assembly100″ relative to the closure tube assembly 5000 about two axes UA-UA andOA-OA that are substantially orthogonal to each other as will bediscussed in further detail below. Also, various embodiments may includea means for actively controlling the pivotal travel of the tool assembly100″ as well as having the capability of passive articulation while alsohaving the ability to lock the tool assembly in the desired articulatedposition. These unique and novel features and advantages will becomefurther apparent as the present Detailed Description proceeds.

In various embodiments, for example, the distal closure tube segment4040 may be formed with a pair of opposed universal pivot arms 4046 thatprotrude in the proximal direction therefrom. The distal end 5002 of theintermediate closure tube segment 5001 may be formed with two opposingfastener arms 5004, 5006 that protrude distally therefrom. See FIGS. 73Aand 74B. Fastener arm 5004 has a pivot hole 5008 therethrough andfastener arm 5006 has a pivot hole 5010 that is substantially coaxiallyaligned with the pivot hole 5008 to define the universal pivot axisUA-UA. Positioned between the fastener arms 5004 and 5006 is a universalring 4070 that has two pairs of pins 4072, 4074 protruding therefromwherein each pin may be spaced ninety degrees from each other about thecircumference of the universal ring 4070 (one pin 4074 is shown indashed lines in FIGS. 73A and 74A). As shown in FIG. 73A, one pin 4072is pivotally received in upper pivot hole 5008 in the fastener arm 5004and the other pin 4072 is pivotally received in the lower pivot hole5010 in the fastener arm 5006. Such arrangement enables the universalring 4070 to pivot about the universal axis UA-UA relative to theclosure tube assembly 5000. Each of the opposed universal pivot arms4046 protruding from the distal closure tube 4040 has a hole 4047therein to pivotally receive a corresponding one of the pins 4074therein to enable the distal closure tube 4040 to pivot relative to theuniversal ring 4070 and closure tube assembly 5000 about an orthogonalaxis OA-OA (shown in FIG. 75) in a first pivotal direction representedby arrow FD in FIG. 73A and second pivotal direction represented byarrow SD in FIG. 73A. Axis UA-UA and OA-OA may be substantiallyorthogonal to each other.

Thus, the person of ordinary skill in the art will appreciate that theabove-described universal ring 4070 arrangement facilitates thearticulation of the distal closure tube 4040 and ultimately toolassembly 100″ which is attached thereto about multiple axes UA-UA andOA-OA relative to the closure tube assembly 5000. In addition, as willbe further described below, in various embodiments, the closure tubeassembly 5000 may be rotatably supported by the handle assembly suchthat it may be rotated around the shaft axis C-C. Because the toolassembly 100″ is affixed to the closure tube assembly 5000 (through thearticulation joint 4006), the tool assembly 100″ is also rotatedtherewith. Such arrangement, therefore, provides a tool assembly 100″that may have a cable driven knife assembly therein and a non-cabledriven anvil closure arrangement with the ability to be articulatedabout several axes.

As can also be seen in FIGS. 73A and 74A, this embodiment may furtherinclude a distal spine segment 4050 that may have an annular retainingflange 4052 formed thereon that is received in a locating groove 4044 inthe distal closure tube 4040. In various embodiments, the articulationjoint 4006 may also include an articulation joint locking assembly,generally designated as 4007, which facilitates the locking of thearticulation joint 4006 after the tool assembly 100″ has beenarticulated to a desired orientation. Such locking assembly 4007 mayinclude a ball-shaped member 4060 that is formed on a neck portion 4054of the distal spine segment 4050. The locking assembly 4007 may furtherinclude a serrated socket member 5030 that is formed on the distal end5022 of an intermediate spine segment 5020 located in a connectorsegment 4004. Serrated socket member 5030 may comprise a plurality ofradially contractable fingers 5032 that define a socket 5034therebetween in which the ball-shaped member 4060 may articulate inmultiple directions. The serrated socket member 5030 is mounted withinthe universal ring 4070.

In various embodiments, a socket locking tube 5080 may be coaxiallyreceived on the disposable spine segment 5020 such that it is axiallymovable relative thereto as will be discussed in further detail below.The distal end 5082 of the locking tube 5080 may be tapered forselective axial contact with the serrated socket member 5030 as thelocking tube 5080 is axially advanced in the distal direction DD tocause the serrated fingers 5032 to radially contract and close aroundthe ball-shaped member 4060 to lock the distal spine segment 4050 (andtool assembly 100″) in position relative to the elongate closure tubeassembly 5000.

The surgical instrument 4000 of various embodiments of the presentinvention may further include an active articulation system generallydesignated as 5090 for actively applying articulation motions to thedistal spine segment 4050. In various embodiments, for example, theactive articulation system 5090 may include four articulating wires 5092that may be fabricated from spring steel or the like and be sufficientlystiff to transfer a compression force applied to a proximal end portionthereof without collapsing. The wires 5092 may be spaced around theserrated socket 5030 at ninety degree intervals from each other and bereceived within corresponding grooves 5033 in the outer surface of thecorresponding radially contractable fingers 5032. The distal end 5094 ofeach wire 5092 may be attached to the neck portion 4054 of the distalspine segment 4050 and the proximal ends 5096 of each wire 5092 may beattached to a hub portion 5102 of a distal wire mount 5100 receivedwithin the closure tube 5000 as shown in FIG. 73B. As will be discussedin further detail below, the distal spine segment 4050 (and toolassembly 100″ attached thereto) may be actively articulated by pullingand pushing the wires 5092.

Also in various embodiments, the proximal facing portion of ball-shapedmember 4060 may have a substantially conical shaped cavity 4062 thereinto accommodate one or more knife actuation cables 5040 that are attachedto a dynamic clamping member (not shown) and/or knife (not shown)mounted within the disposable tool assembly 100″. The proximal end 5042(FIG. 73A) of the cable 5040 may be attached to a knife nut 5050 that isthreadably journaled on a knife screw 5060. As can be seen in FIGS. 73Aand 75, the knife nut 5050 has a pair of laterally protruding tabs 5052that are axially received in corresponding axially extending slots 5024in the disposable spine segment 5020. The person of ordinary skill inthe art will appreciate that such arrangement permits the knife nut 5050to move axially in the proximal direction PD or distal direction DD asthe knife screw 5060 is rotated.

As indicated above, the disposable reload unit 4002 in variousembodiments may be constructed to be disposable after one use. Tofacilitate quick detachment of a reload unit 4002 and reattachment of anew reload unit 4002 without the use of tools, a quick disconnect joint4008 may be employed. As used herein, the term “quick disconnect” refersto the ability to detach one component from another component withoutthe use of tools. The operation and construction of various embodimentsof the quick disconnect joint 4008 may be understood from reference toFIGS. 73B, 74B, and 76. As can be seen in FIGS. 73B and 74B, the closuretube assembly 5000 comprises an intermediate closure tube segment 5001and a proximal closure tube segment 5020. As can be seen in FIGS. 73Band 76, the proximal end of the intermediate closure tube segment 5001has a series of radial gear teeth 5003 formed thereon for meshingengagement with gear teeth 5124 (not shown in FIG. 76) on a distal end5122 of a proximal closure tube segment 5120 (not shown in FIG. 76) whenthe disposable reload unit 4002 is attached the proximal closure tubesegment 5120.

To support the removable interconnection between the disposable reloadunit 4002 and the proximal closure tube segment 5120, a connectionspider 5150 may be employed. The connection spider 5150 may be partiallyreceived within the proximal end of the intermediate closure tubesegment 5001 and protrude therefrom such that when the intermediateclosure tube segment 5001 is coupled to the proximal closure tubesegment 5120, a portion of the connection spider 5150 protrudes into thedistal end 5122 of the proximal closure tube segment 5120. In variousembodiments, the connection spider may be pinned within the proximal endof the intermediate closure tube segment 5001 by a pin 5151, adhesive orother suitable fastener arrangements. See FIG. 76.

In various embodiments, the connection spider 5150 may also be journaledon a disposable spine segment 5020 and configured to receivecorresponding actuator bars 5104 that protrude from a distal wire mount5100. The proximal end 5106 of each actuator bar 5104 may contain atapered detent to facilitate interconnection with a plurality ofproximal wire connector members 5160. In one embodiment for example,four proximal wire connector members are employed. The plurality ofactuator bars 5104 may be provided with a detent 5108 for receiving acorresponding connector ball 5164 mounted within tapered bore detent5162 in each of the proximal wire connectors 5160. See FIGS. 73B and 77.Thus, four connector balls 5164 are employed—one for each proximal wireconnector 5160. As can also be seen in FIGS. 73B, 78, and 79, theproximal end 5021 of the disposable spine segment 5020 has a proximallyextending connection portion 5023 that may have an internal collarportion 5025 formed therein to support a proximal end portion 5062 ofthe knife screw 5060. In addition, the proximally extending connectionportion 5023 may have an external spine key 5026 formed thereon forreceipt in a key slot 5206 formed in a distal end 5202 of the proximalspine segment 5200. The proximal end 5062 of the knife screw 5060 may besupported in a bearing 5064 and have a splined drive portion 5066 fornon-rotatable receipt in a spline drive cavity 5224 in the distal end5222 of a knife drive shaft 5220. See FIG. 78

Turning next to FIGS. 74A and 74B, the attachment of the locking tube5080 may be understood. As can be seen in FIG. 74A, the locking tube5080 a pair of brake actuator arms 5084 protrude proximally therefrom.FIG. 74B is a cross-section that is rotated approximately 45 degreesfrom the cross-section shown in FIG. 73B. As can be seen in FIG. 74B,each brake actuator arm 5084 has a detent 5085 formed therein forreceiving connector balls 5168 mounted within tapered bore detents 5166in a corresponding proximal brake actuator arm 5300. See FIGS. 74B and77. To provide the brake actuator arm 5084 with sliding lateral support,each brake actuator arm 5084 may be slidably received in a correspondinggroove 5027 in the disposeable spine segment 5020. See FIGS. 75 and 76.

As can also be seen in FIG. 73B, an outer proximal spine segment 5400may be received within the proximal closure tube 5120 and cooperatestherewith to define a spring cavity 5402 for receiving a closure tubespring 5410 therein. The proximal end 5126 of the proximal closure tubesegment 5120 may have an enlarged knob portion 5128 thereon tofacilitate the application of control motions thereto by the clinician.A pocket 5130 may be formed in the knob portion 5128 for receiving aclip ring 5132 therein that is affixed to the outer proximal spinesegment 5400. Thus, the closure tube spring 5410 serves to bias theproximal closure tube segment 5120 into meshing engagement with thedisposable closure tube segment 5000. As can be seen in FIGS. 73B and78, the distal end 5122 of the proximal closure tube segment 5120 has alarger internal diameter 5123 that has a tapered surface 5125 Todisengage the tool assembly 100″ from the instrument 4000, the cliniciandraws the knob 5128 in the proximal direction PD against the force ofthe spring 5410 until the larger internal diameter portion 5123 isoriented in registration with the connector balls 5164 to enable theconnector balls 5164 to move out of engagement with the detents 5108 inthe proximal ends 5106 of the actuator bars 5104 of the distal wiremount 5100 when the user applies a removal force to the tool assembly100″ pulling it in the distal direction DD.

FIGS. 78-81 illustrate the attachment of a disposable reload unit 4002to the instrument portion 4000. With particular reference to FIG. 78,the clinician orients the unit 4002 such that the spline portion 5066 ofthe knife screw 5060 is aligned with the internal spline cavity 5224 inthe knife drive shaft 5220 and inserts the proximal end of the splinedrive portion 5066 therein. See FIG. 79. Thereafter, the clinicianaligns the spine key 5026 on the proximal end 5021 of the disposablespine segment with the key slot 5206 in the proximal spine segment 5200.See FIGS. 79 and 80. The clinician then continues to insert the proximalend 5106 into the area 5161 between the four proximal wire connectors5160 and the proximal spine segment 5200. See FIG. 80. The clinician maythen move the closure knob 5128 in the proximal direction to enable theconnector balls 5164 to move radially outward as the proximal ends 5106of the actuator bars 5104 are pushed proximally into position. Theclinician then releases the knob 5128 to permit the proximal closuretube 5120 to move distally locking the connector balls 5164 in thedetents 5108 in the actuator bars 5104 of the distal wire mount 5100 toaffix the four proximal wire connectors 5160 to the distal wire mount5100 and also lock the connector balls 5168 in the detents 5085 in thebrake actuator arms 5084. In addition, the radial gears 5003, 5124 areretained in meshing engagement with each other.

FIGS. 82-84 depict one embodiment that may be used to articulate thetool assembly 100″ relative to the connector segment 4004 and provideactuation thereto. As can be seen in FIG. 82, the instrument 4000 mayfurther include a handle assembly 5500 that may be formed from twohousing sections 5510 (only one housing section 5510 is shown in FIG.82) that may be connected together by screws, snaps, adhesive, etc. Invarious embodiments, the handle assembly 5500 may take the form of a“pistol-grip” type housing with a hand grip portion 5512. As can be seenin FIG. 82, an attachment flange 5404 may be formed on the proximal endof the outer proximal spine segment 5400 for affixing the outer proximalspine segment 5400 to the handle assembly 5500. The flange 5404 may beattached to the handle housing 5500 by adhesive or other mechanicalfastener arrangements, screws, snaps, slots, etc. Likewise, the proximalend 5204 of the proximal spine segment 5200 may have a flange 5210 foraffixing the proximal spine segment 5200 to the handle assembly 5500.The flange 5210 may be attached to the handle housing 5500 by adhesiveor other mechanical fastener arrangements, screws, snaps, slots, etc.

In various embodiments, the active articulation system 5090 may furthercomprise an articulation control system, generally designated as 5600,that is operably supported by the handle assembly 5500 and interfaceswith the articulation wires 5092. As can be seen in FIG. 82,articulation control system 5600 may comprise a joy stick assembly 5602to which the proximal ends 5170 of each of the proximal wire connectors5160 are pivotally connected. In one embodiment, for example, a joystick assembly 5602 may include an articulation ball 5610 that isrotatably supported in a socket 5520 in the handle assembly 5500. Invarious embodiments, each proximal end 5170 of the proximal wireconnectors 5160 may have a spherical ball bearing 5172 supported thereonto receiving a bearing mount pin 5612 to attach the proximal wireconnectors 5160 to the articulation ball 5610. Other fastenerarrangements could also be employed however. In addition, anarticulation knob 5620 may be attached to the articulation ball 5610.

Thus, to articulate the tool assembly 100″ relative to the connectorsegment 4004, the clinician can grasp the hand grip portion 5512 in onehand and the articulation knob 5620 in the other hand. By manipulatingthe articulation knob 5620, the clinician can apply articulation motionsto the distal wire mount 5100 and ultimately to the four articulationwires 5092 attached thereto which, in turn, impart the articulationmotion to the distal spine segment 4050 which will cause the toolassembly 100″ to articulate relative to the connector segment 4004 ofthe disposable reload unit 4002. Thus, the clinician can effectivelysteer the tool assembly 100″ through use of the joy stick assembly 5602.

The position of the tool assembly 100″ may be locked in position by abrake control system generally designated as 5640. As can be seen inFIGS. 82 and 84, a brake control system 5640 may include a driver disc5642 that is movably journaled on the knife drive shaft 5220 forselective axial movement therealong without impeding the rotation of theknife drive shaft 5220. As can be seen in FIG. 84, each proximal brakeactuator arm 5300 has a proximal end 5302 that is affixed to the drivedisc 5642. A brake yoke 5650 may be coupled to the driver disc 5642 by apair of pins 5643 that protrude into circumferentially extending groove5644 formed in the driver disc 5642. The brake yoke 5650 may bepivotally supported by the housing assembly 5500 on a brake yoke pivotpin 5652. As can be seen in FIG. 84, in various embodiments, a braketrigger 5654 is formed on the lower portion of the brake yoke 5650. Thebrake trigger 5654 may have a lock arm 5656 protruding therefrom into anopening 5506 in the housing assembly 5500. A lower portion of the lockarm 5656 may have lock teeth 5658 formed thereon to engage a lockingwall portion 5508 of the housing assembly 5500.

Various embodiments of the present invention may also employ a brakerelease mechanism 5660 for locking and unlocking the brake trigger 5654.As can be seen in FIG. 84, one form of a release mechanism 5660 mayinclude a locking button 5662 that has a release button portion 5664 andis movably supported by the handle assembly 5500 in the positionillustrated in FIG. 84. As can be seen in that Figure, the lockingbutton 5664 may have a conical shaped end portion 5666 that has a neckthat extends to a conical portion (not shown) of the release buttonportion 5664. When the clinician pushes the release button portion 5664in a first direction, the conical portion 5666 contacts the lock arm5656 and lifts it out of engagement with the locking wall portion 5508to thereby enable the trigger 5654 to pivot. A spring (not shown) couldbe used to retain the locking button 5662 in the locked position. Oncethe trigger 5654 is pivoted to the desired position, the user simplypushes the release portion 5664 in an opposite direction to move theconical portion 5666 out of engagement with the lock arm 5656 to permitit to engage the locking wall portion 5508 once again. Thus, once theclinician has articulated the tool assembly 100″ to the desiredposition, the clinician squeezes the brake trigger 5654 toward thehandle assembly 5500. Such action causes the brake yoke 5650 and thedriver disc 5642 to move the brake arms 5300 in the distal direction DDwhich drives the locking tube 5080 in the distal direction DD to lockthe fingers 5032 around the ball-shaped member 4060. Once the fingers5032 have been locked around the ball-shaped member 4060, the cliniciancan push the locking button in a direction which permits one of theteeth 5658 on the locking arm 5656 to engage the locking wall portion5508 and retain the brake release mechanism in the locked position. Whenthe clinician desires to unlock the tool assembly 100″ and perhapsrearticulate it, the clinician simply pushes the locking trigger releasebutton portion to permit the trigger 5654 to be pivoted away from thehandle assembly 5500 and thereby move the brake arms 5300 proximally.

In various embodiments of the present invention, rotational motion maybe applied to the knife drive shaft 5220 by means of a drive systemgenerally designated as 5700. As can be seen in FIGS. 82 and 83, in oneembodiment, the drive system 5700 may include a firing handle 5702 thatis pivotally or otherwise actuatably coupled to the handle assembly5500. In one embodiment for example, the firing handle 5702 may bepivotably attached to the handle assembly 5500 by a pivot pin 5704.Attached to the firing handle is a firing gear 5706 that is oriented topivot with the firing handle 5702. The firing gear 5706 may be inmeshing engagement with a ratchet drive gear 5708 that is mounted to aratchet drive shaft 5710. Ratchet drive shaft 5710 may be attached to aratchet clutch assembly 5720.

In various embodiments, a ratchet clutch assembly 5720 may include afirst clutch plate 5722 that is attached to the ratchet shaft 5710 andwhich is in meshing engagement with a second ratchet clutch plate 5724that is mounted to an output shaft 5726. The second clutch plate 5724may be biased into meshing engagement with the first clutch plate 5722,by ratchet spring 5730. A ratchet output gear 5740 may be attached tothe ratchet output shaft 5726 which is arranged for meshing engagementwith a drive gear 5750 mounted to a bevel drive shaft 5752. An inputbevel gear 5760 may be mounted on the bevel drive shaft 5752 and be inmeshing engagement with an output bevel gear 5770 that is mounted to anoutput shaft 5780. An output gear 5782 is mounted to the output shaft5780 and is in meshing engagement with a knife drive gear 5790 attachedto the proximal end 5226 of the knife drive shaft 5220.

Thus, to rotate the knife drive shaft 5220 and drive the knife nut 5050in the proximal direction PD and actuate the dynamic clamping assembly(not shown) and knife arrangement (not shown) by means of the knifeactuation cables 5040, the clinician grasps the handle assembly andratchets the firing handle 5702 back and forth toward the grip portion5512. Movement of the firing handle 5512 in that manner will cause thedrive system 5700 to impart a rotary motion to the knife drive shaft5220 and ultimately to the knife screw 5060 to cause the knife nut 5050to move in the proximal direction. After the firing sequence has beencompleted, the clinician can detach the reload unit 4002 and reattachanother reload unit and repeat the process. In alternative embodiments,the knife drive shaft may be rotated by means of a motor and planetarygear drive. The motors may be battery powered or powered withalternating current. Other drive arrangements could also be employed.

FIGS. 85-89 illustrate another surgical instrument embodiment 6000 thatemploys an active or controllable articulation joint arrangement 6010.As can be seen in FIGS. 85 and 86, one embodiment may employ a closuretube 6020 of the type and construction described above. The closure tube6020 has a proximal end (not shown) that may interface with variousclosure tube control mechanisms supported by the handle assembly forproviding actuation forces thereto. The closure tube 6020 may alsointerface with one of the various tool assemblies described above toapply opening or opening and closing forces to the anvil assemblythereof. Also in this embodiment, a spine member 6030 may extend fromthe handle assembly (not shown) through the closure tube 6020. Again,the proximal end (not shown) of the spine member 6030 may be operablysupported by the handle assembly (not shown) in the various mannersdescribed above or in other known manners. In various embodiments, thedistal end 6032 of the spine member 6030 may be formed with a top spinearm 6034 and a bottom spine arm 6036 that protrude in the distaldirection DD from the distal end 6032 of the spine member 6030. The topspine arm 6034 has a pivot hole 6037 therethrough and the bottom spinearm 6036 has a pivot hole 6039 that is substantially coaxially alignedwith the pivot hole 6037 along a vertical axis VA-VA.

The various embodiments may also include a horizontal locking tube 6040that extends through the spine member 6030. The horizontal locking tube6040 has a proximal end (not shown) that is supported by the handleassembly (not shown) and which may interface with an actuationarrangement (not shown) for axially advancing the horizontal lockingtube 6040 axially in the proximal direction PD and distal direction DDwithin the spine member 6030 and for selectively retaining or lockingthe horizontal locking tube 6040 in a desired axial position. Inaddition, the actuation arrangement for the horizontal locking tube 6040may also employ a spring or other arrangement for biasing the horizontallocking tube 6040 in the proximal direction PD after the horizontallocking tube 6040 has been unlocked. As can be seen in FIG. 86, thehorizontal locking tube 6040 has a top or first locking bar 6042 thathas a series of top or first teeth 6044 formed therein. The horizontallocking bar 6040 further has a bottom or second locking bar 6046 thathas a series of bottom or second teeth 6048 formed in the distal endthereof.

Also in these embodiments, a vertical locking tube 6050 may extendthrough the horizontal locking tube 6040. The vertical locking tube 6050has a proximal end (not shown) that is supported by the handle assembly(not shown) and which may interface with an actuation arrangement (notshown) for axially advancing the vertical locking tube 6050 axially inthe proximal direction PD and distal direction DD within the horizontallocking tube 6040 and for selectively retaining or locking the verticallocking tube 6050 in a desired axial position. In addition, theactuation arrangement for the vertical locking tube 6050 may also employa spring or other arrangement for biasing the vertical locking tube 6050in the proximal direction PD after the vertical locking tube 6050 hasbeen unlocked. In various embodiments, for example, the actuationarrangement employed may be configured to actuate, lock and release thehorizontal locking tube 6040 and the vertical locking tube 6050 insimultaneous motions.

As can be seen in FIG. 86, in various embodiments, for example, thevertical locking tube 6050 has a first vertical lock tine 6052 and asecond vertical lock tine 6054. Various embodiments may employ a toolassembly of the types described above that use a cable driven dynamicclamping member and/or knife arrangement. The vertical locking tube mayhave a cable passage 6056 therethrough to accommodate the drive cables(not shown) that pass from the tool assembly to the handle assembly.

In various embodiments, the first and second vertical locking tines6052, 6054 are oriented for engagement with a vertical locking block6060. In one embodiment, for example, the vertical locking block 6060may have a first lateral locking column 6062 that has a series of firstlateral teeth 6064 thereon and a second lateral column 6066 that has aseries of second lateral teeth 6068 thereon. The first lateral lockingcolumn 6062 and the second lateral locking column 6066 are arranged in aspaced apart relation to each other by an upper or first lateral crossbar 6070 and a bottom or second lateral cross bar 6072 that are arrangedin a spaced apart relationship to each other to define anactuator-receiving passage 6074 therebetween. In various embodiments,the vertical locking block 6060 may be configured for axial travel inthe proximal direction PD and distal direction DD relative to anarticulation member or block 6080 in response to an actuation motionfrom the vertical locking tube 6050. The vertical locking block 6060 maybe supported for axial travel toward and away from the articulationblock 6080 by a pair of pins 6076 and 6078 that extend into holes 6077,6079 in the vertical lock block 6060 and holes (not shown) inarticulation block 6080.

As can be seen in FIGS. 85 and 86, the articulation block 6080 may havea longitudinal passage 6082 therethrough for accommodating the drivecables (not shown). In addition, a first vertical pin 6084 is receivedin a hole 6083 in the articulation block and protrudes therefrom to bereceived in the first pivot hole 6037 in the top or first upper arm 6037of the spine member 6030. Likewise, a lower pin 6089 protrudes from thebottom surface of the articulation block 6080 to be pivotally receivedin the bottom or second pivot hole in the bottom or second arm 6036 ofthe spine member 6030 such that the articulation block 6080 mayselectively pivot about the vertical axis VA-VA. Also in variousembodiments, a proximal end of an elongate channel assembly 6090 thatmay comprise a portion of the tool assembly may have a first clevisportion or arm 6092 and a second clevis portion or arm 6094 extending inthe proximal direction therefrom. The proximal facing face 6096 of thefirst clevis arm 6092 has a first set of horizontal locking teeth 6068formed thereon for selective engagement with a corresponding set ofsecond horizontal locking teeth 6064 on the first lateral locking column6062. Likewise, the proximal facing face 6100 of the second clevis arm6094 has another set of first horizontal locking teeth 6102 formedthereon for selective meshing engagement with another corresponding setof second horizontal locking teeth 6068 on the second lateral lockingcolumn 6062 on the vertical lock block 6060. The first clevis arm 6092may have a first pivot hole 6093 therethrough that is adapted topivotally receive a pivot pin 6110 protruding from the articulationblock 6080 and the second clevis arm 6094 may have a second pivot hole6095 therethrough for pivotally receiving a second pivot pin 6112protruding from the articulation block 6080 such that the channelassembly 6090 may selectively pivot relative to the articulation block6080 about horizontal axis HA-HA.

As can also be seen in FIG. 86, a first horizontal lock segment 6120 maybe attached or integrally formed on an upper surface 6081 of thearticulation block 6080 and have a series of first vertical lockingteeth 6122 formed therein for engagement with a corresponding set ofsecond vertical locking teeth 6044 formed in the top or first horizontallocking bar 6042. Likewise, a second horizontal lock segment 6130 may beattached to or integrally formed with a bottom surface 6083 of thearticulation block 6080 and have another series of first verticallocking teeth 6132 formed therein for engagement with a correspondingset of second vertical locking teeth 6048 on the second or bottomlocking bar 6046.

To enable the user to actively articulate the tool assembly (channelassembly 6090) the articulation joint 6010 may be provided with ahorizontal actuator bar 6140 and a vertical actuator bar 6150. Thehorizontal actuator bar 6140 may be fabricated from plastic material,spring steel, etc., for example. The distal end 6142 of the horizontalactuator bar 6140 may be formed with a spherical ball bearingarrangement of the type described above and be pinned to or otherwiseattached to the articulation block 6080. The proximal end (not shown) ofthe horizontal actuator bar 6140 may be operably attached to a joy stickassembly of the type described above operably supported in the handleassembly or other actuation arrangement for applying pushing and pullingmotions to the horizontal actuator bar 6140. As can be seen in FIGS. 85and 86, the distal end 6152 of the vertical actuator bar 6150 may becoupled to an extension block 6097 formed on the second clevis arm 6094.The distal end 6152 may be fixedly attached to the extension block 6097or have a spherical ball bearing formed thereon to be pivotally attachedthereto. The proximal end (not shown) of the vertical actuator bar 6150may be operably attached to a joy stick assembly of the type describedabove operably supported in the handle assembly or other actuationarrangement for applying pushing and pulling motions to the verticalactuator bar 6150. in alternative embodiments, either the verticalactuator bar 6150 or the horizontal actuator bar 6140 may be omitted. Inthose embodiments, for example, if the horizontal actuator bar 6140 isomitted, the vertical actuator bar 6150 can be employed to articulatethe channel assembly 6090 (and tool assembly) about the horizontal axisHA-HA and the clinician can articulate the channel assembly 6090 (andtool assembly) about the vertical axis by releasing (unlocking) thehorizontal locking tube 6040 and bringing the tool assembly into contactwith a portion of the patient's body or another surgical instrument toapply a pivoting force to the channel assembly (and tool assembly) tocause them to pivot about vertical axis VA-VA until they are positionedin the desired position at which time the horizontal locking tube 6040may be advanced into locking engagement with the horizontal lock members6120, 6130. Similarly, if the vertical actuator bar is omitted, thehorizontal actuator bar can be employed to articulate the channelassembly 6090 (and tool assembly) about the vertical axis VA-VA and theclinician can articulate the channel assembly 6090 (and tool assembly)about the horizontal axis HA-HA by releasing (unlocking) the verticallocking tube 6050 and bringing the tool assembly into contact with aportion of the patient's body or another surgical instrument to apply apivoting force to the channel assembly 6090 (and tool assembly) to causethem to pivot about horizontal axis HA-HA until they are positioned inthe desired position at which time the vertical locking tube 6050 may beadvanced into locking engagement with the horizontal locking teeth 6068,6102 on the channel devises 6092, 6094, respectively.

FIGS. 90-105 illustrate another surgical instrument embodiment 7000 ofthe present invention, that may be disposed of after use. However, theunique and novel features of these embodiments may be employed inconnection with several of the embodiments discussed above withoutdeparting from the spirit and scope of the present invention. As can beseen in FIG. 90, the tool assembly 7002 includes an anvil assembly 7010that is pivotally coupled to a channel assembly 7020 of the type andconstruction described above for operably receiving a staple cartridge7021 therein. The anvil assembly 7020 has a proximal end 7012 that hastwo anvil trunnions 7014 protruding therefrom that are adapted to bereceived within corresponding open ended slots 7024 in the walls 7022 ofthe proximal end 7021 of the channel assembly 7020. As can also be seenin FIGS. 90-95, the instrument 7000 may further include a spine member7030 that has a distal end 7032 that may be attached to the proximal end7021 of the channel assembly 7020.

These embodiments may also employ a closure tube 7040 that may beconstructed and operated in any one of the above-described manners. Forexample, the distal end 7042 may be constructed for selective axialcontact with a proximal facing ledge 7016 formed in the anvil assembly7010 such that as the closure tube 7040 is moved in the distal directionDD, the distal end 7042 contacts the ledge 7016 and causes the anvilassembly 7010 to pivot to the closed position (FIGS. 90-92) while thetrunnions 7014 are constrained to pivot in their respective slots 7024by a trunnion lock bar 7050 as will be discussed in further detailbelow. The proximal end (not shown) of the closure tube 7040 may besupported by actuation components of the type and construction describedabove in the handle assembly (not shown) to selectively control theaxial movement of the closure 7040 in the distal direction DD andproximal direction PD.

As can be seen in FIG. 90, the trunnion lock bar 7050 may be slidablysupported in an axial slot 7034 provided in the spine 7030. The proximalend (not shown) of the trunnion lock bar 7050 may interact withactuation members in the handle assembly to move the trunnion lock bar7050 in the distal direction DD and the proximal direction PD andselective retain the bar 7050 in those positions. As can be further seenin FIGS. 92 and 94, the distal end 7052 of the trunnion lock bar 7050may have two trunnion retention arms 7054 protruding therefrom.

FIGS. 90-92 illustrate the trunnion lock bar 7050 in the locked positionwherein the trunnion retention arms 7054 retain the trunnions in theirrespective open ended slots 7024 in the channel assembly 7020. As can beseen in those Figures, when in that position, the anvil assembly 7010may be in the closed (clamped) position. After the stapling procedurehas been completed (e.g., after the dynamic clamping member/knifeassembly has been driven from the proximal end 7004 of the tool assembly7002 to the distal end 7006 of the tool assembly 7002), the cliniciancan retract the closure tube and the trunnion lock bar 7050 in theproximal direction to permit the trunnions 7014 to popup through theopen end 7025 of each slot 7024 as shown in FIG. 95. When the proximalend 7012 of the anvil assembly 7010 is in the position illustrated inFIG. 95, the person of ordinary skill in the art will understand thatthe tissue that was once clamped between the anvil assembly 7010 and thestaple cartridge 7021 can now be released therefrom.

FIGS. 104 and 105 illustrate an alternative surgical instrument 4000′embodiment that may have portions that are substantially identical inconstruction and operation as the surgical instrument 4000 describedabove. In the embodiment depicted in FIGS. 104 and 105, however, theslots 4014′ are opened ended to permit the trunnions 4022′ to becomedisengaged therefrom. As can be seen in FIG. 104, when the closure ring4030 has been advanced to its distal-most position to close the anvilassembly 4020, the closure ring 4030 also serves to retain the anvilassembly 4020′ in the clamped position by virtue of its bearing on theproximal end portion 4024′ of the anvil assembly 4020′. When the closurering 4030 is advanced to its proximal-most position as shown in FIG.105, the trunnions 4022′ are free to move out of the open ended slots4014′ in the elongate channel assembly 4012′. Surgical instrument 4000′may otherwise operate in an identical manner as surgical instrument 4000which was described in detail above.

Also in various embodiments, to completely release the anvil assembly7010, the anvil assembly 7010 may be provided with a spring member 7100that is attached to the underside 7011 of the anvil assembly 7010 asshown in FIG. 95. As can be seen in that Figure, the dynamic clampingmember 150 which is configured to be driven by one or more drive cables7110, 7112 within the elongate channel assembly 7020 by drive cables maybe provided with a pin 159 that is oriented to be slidably received in aslot 7018 in the anvil assembly 7010. The pin 159 serves to draw theanvil assembly 7010 toward to the elongate channel assembly 7020 as thedynamic clamping assembly 150 is driven in the distal direction DDthrough the elongate channel assembly 7010. As can be seen in FIG. 95,the distal end 7102 of the spring member 7120 extends downwardly toengage the pin 159 when the dynamic clamping assembly 150 has reachedits distal-most position as illustrated in FIG. 95. Thereafter, pullingor otherwise moving the dynamic clamping assembly 150 in the proximaldirection will result in the spring 7102 dislodging the pin 159 from theslot 7018.

Various embodiments of a dynamic clamping assembly 150 are illustratedin FIGS. 96-103. As can be seen in those Figures, a dynamic clampingmember 150 may include an upper portion 157, a central support or upwardextension 151, and a bottom portion 152 which cooperates to slidinglyretain dynamic clamping member 150 along an ideal cutting path duringlongitudinal, distal movement thereof within the elongate channelassembly 7020. The leading cutting edge 155, here, knife blade 155 a, isdimensioned to ride within a slot formed in the staple cartridge 7021and separate tissue once stapled. It is envisioned that leading edge 155of the dynamic clamping member 150 may be serrated, beveled or notchedto facilitate tissue cutting. The dynamic clamping member 150 may bedriven by one or more drive cables 7100, 7112. To facilitate attachmentof said drive cables 7110, 7112, the dynamic clamping assembly 150 maybe provided with attachment apertures 7130 and ledges 7132. However,other attachment arrangements and drive configurations could beemployed.

Turning to FIG. 96, the upper portion 157 of the dynamic clamping memberis provided with an open ended slot 7140 for receiving the pin 159therein. Once the pin 159 contacts the spring 7100, the pin 159 may beforced out of the open ended slot 7140. The dynamic clamping memberembodiment of FIG. 97 is substantially identical to the embodiment ofFIG. 96, except that the upper portion 157 has a reinforcement member7150 formed thereon. In the embodiment of FIG. 98, an undercut portion7160 is provided in the upper portion and the slot 7162 is initiallycrimped closed. When the pin 159 contacts the spring 7100, the bottomportion 7164 forming the slot is permitted to bend downward to releasethe pin 159. In the embodiment depicted in FIG. 99, the slot 7170supporting the pin 159 is defined by a bendable flap 7172 that can bebent or deformed to open the slot 7170 to permit the pin to be removedtherefrom as illustrated in FIG. 100. The embodiment depicted in FIG.101 has a second slot 7190 that communicates with the first pin slot7180 that enables the first pin slot to be opened to a point wherein thepin can be released therefrom. In the embodiments depicted in FIGS.96-101, the pin 159 has a substantially circular cross-sectional shape.In the embodiment depicted in FIGS. 102 and 103, the pin 159′ isprovided with lateral wings or gussets 7200 to provide additionalsupport to the pin 159′ and minimize any likelihood of the pin bendingas the dynamic clamping member 150 is driven through the elongatechannel assembly 7020.

While several embodiments of the invention have been described, itshould be apparent, however, that various modifications, alterations andadaptations to those embodiments may occur to persons skilled in the artwith the attainment of some or all of the advantages of the invention.For example, according to various embodiments, a single component may bereplaced by multiple components, and multiple components may be replacedby a single component, to perform a given function or functions. Thisapplication is therefore intended to cover all such modifications,alterations and adaptations without departing from the scope and spiritof the disclosed invention as defined by the appended claims.

The devices disclosed herein can be designed to be disposed of after asingle use, or they can be designed to be used multiple times. In eithercase, however, the device may be reconditioned for reuse after at leastone use. Reconditioning may include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, the devicemay be disassembled, and any number of particular pieces or parts of thedevice can be selectively replaced or removed in any combination. Uponcleaning and/or replacement of particular parts, the device may bereassembled for subsequent use either at a reconditioning facility, orby a surgical team immediately prior to a surgical procedure. Those ofordinary skill in the art will appreciate that the reconditioning of adevice may utilize a variety of different techniques for disassembly,cleaning/replacement, and reassembly. Use of such techniques, and theresulting reconditioned device, are all within the scope of the presentapplication.

Preferably, the invention described herein will be processed beforesurgery. First a new or used instrument is obtained and, if necessary,cleaned. The instrument can then be sterilized. In one sterilizationtechnique, the instrument is placed in a closed and sealed container,such as a plastic or TYVEK® bag. The container and instrument are thenplaced in a field of radiation that can penetrate the container, such asgamma radiation, x-rays, or higher energy electrons. The radiation killsbacteria on the instrument and in the container. The sterilizedinstrument can then be stored in the sterile container. The sealedcontainer keeps the instrument sterile until it is opened in the medicalfacility.

Any patent, publication, or other disclosure material, in whole or inpart, that is said to be incorporated by reference herein isincorporated herein only to the extent that the incorporated materialsdoes not conflict with existing definitions, statements, or otherdisclosure material set forth in this disclosure. As such, and to theextent necessary, the disclosure as explicitly set forth hereinsupersedes any conflicting material incorporated herein by reference.Any material, or portion thereof, that is said to be incorporated byreference herein, but which conflicts with existing definitions,statements, or other disclosure material set forth herein will only beincorporated to the extent that no conflict arises between thatincorporated material and the existing disclosure material.

The invention which is intended to be protected is not to be construedas limited to the particular embodiments disclosed. The embodiments aretherefore to be regarded as illustrative rather than restrictive.Variations and changes may be made by others without departing from thespirit of the present invention. Accordingly, it is expressly intendedthat all such equivalents, variations and changes which fall within thespirit and scope of the present invention as defined in the claims beembraced thereby.

1. A surgical instrument comprising: an elongate channel assemblyconstructed to operably support a staple cartridge assembly therein; aknife assembly oriented for travel within said elongate channelassembly; at least one cable transition support operably mounted to atleast one of said elongate channel assembly and said knife assembly; adrive cable operably extending around at least a portion of said atleast one cable transition support and interfacing with a cable drivesystem to drive said knife assembly within said elongate channelassembly; and a cable retention arrangement for operably retaining saiddrive cable around said at least a portion of said cable transitionsupport.
 2. The surgical instrument of claim 1 wherein said at least onesaid cable transition support comprises a pulley.
 3. The surgicalinstrument of claim 2 wherein said cable retention arrangement comprisesa cable retention block in close proximity to said pulley.
 4. Thesurgical instrument of claim 3 wherein said cable retention block has anarcuate surface that is complementary-shaped relative to the portion ofthe drive cable on said pulley such that said drive cable is preventedfrom becoming disengaged from said pulley.
 5. The surgical instrument ofclaim 1 wherein said at least one cable transition support comprises ablock having a passage extending therethrough that forms an arcuatebearing surface over which said drive cable passes.
 6. The surgicalinstrument of claim 1 wherein said cable retention arrangement comprisesa cable tensioning joint attached to said drive cable for maintainingtension therein.
 7. The surgical instrument of claim 6 wherein saiddrive cable has first and second ends and wherein said cable tensioningjoint comprises: a first stop member affixed to said first end of saiddrive cable; a second stop member affixed to said second end of saiddrive cable and having a passage therethrough for receiving a portion ofsaid drive cable therethrough such that said second stop member can moveon said drive cable relative to said first stop member; a third stopmember fixedly attached to a portion of said drive cable such that saidsecond stop member is movably received between said first stop memberand said third stop member on said portion of said drive cable; and atension spring attached to said second stop member and said third stopmember.
 8. The surgical instrument of claim 7 wherein said cable drivesystem comprises a driven pulley that drivingly supports a portion ofsaid drive cable thereon and wherein said at least one cable transitionsupport comprises: first and second pulleys mounted on a distal end ofsaid elongate channel assembly; and a third pulley mounted on said knifeassembly.
 9. The surgical instrument of claim 8 further comprising: ahandle assembly operably supporting said driven pulley; an elongateshaft operably attached to said handle assembly and said elongatechannel assembly and supporting said drive cable therein; and anarticulation joint in said elongate shaft to enable said elongatechannel assembly to articulate relative to said handle assembly.
 10. Amethod for processing an instrument for surgery, the method comprising:obtaining the surgical instrument of claim 1; sterilizing the surgicalinstrument; and storing the instrument in a sterile container.
 11. Asurgical instrument, comprising: an elongate channel assemblyconstructed to operably support a staple cartridge therein; a knifeassembly oriented for travel within said elongate channel assembly;first and second distal cable transition supports on said distal end ofsaid elongate channel assembly; a second cable transition support onsaid knife assembly; a drive cable extending around at least a portionof said first and second distal cable transition supports and saidsecond cable transition support on said knife assembly and interfacingwith a cable drive system to drive said knife assembly within saidelongate channel assembly; and at least one a cable retentionarrangement for retaining said drive cable around at least one of saidfirst and second distal cable transition supports and said second cabletransition support.
 12. The surgical instrument of claim 11 wherein atleast one of said first and second distal cable transition supports andsaid second cable transition support comprises a pulley.
 13. Thesurgical instrument of claim 12 wherein said cable retention arrangementcomprises a retention block in close proximity to said pulley.
 14. Thesurgical instrument of claim 13 wherein said cable retention block hasan arcuate surface that is complementary-shaped relative to the portionof the drive cable on said pulley such that said drive cable isprevented from becoming disengaged from said pulley.
 15. The surgicalinstrument of claim 11 wherein said at least one cable transitionsupport comprises a block having a passage extending therethrough thatforms an arcuate bearing surface over which said drive cable may pass.16. The surgical instrument of claim 11 wherein said cable retentionarrangement comprises a cable tensioning joint attached to said drivecable for maintaining tension therein.
 17. The surgical instrument ofclaim 16 wherein said drive cable has first and second ends and whereinsaid cable tensioning joint comprises: a first stop member affixed tosaid first end of said drive cable; a second stop member affixed to saidsecond end of said drive cable and having a passage therethrough forreceiving a portion of said drive cable therethrough such that saidsecond stop member can move on said drive cable relative to said firststop member; a third stop member fixedly attached to a portion of saiddrive cable such that said second stop member is movably receivedbetween said first stop member and said third stop member on saidportion of said drive cable; and a tension spring attached to saidsecond stop member and said third stop member.
 18. The surgicalinstrument of claim 17 wherein said cable drive system comprises adriven pulley that drivingly supports a portion of said drive cablethereon.
 19. The surgical instrument of claim 8 further comprising: ahandle assembly operably supporting said driven pulley therein; anelongate shaft operably attached to said handle assembly and saidelongate channel assembly and supporting said drive cable therein; andan articulation joint in said elongate shaft to enable said elongatechannel assembly to articulate relative to said handle assembly.
 20. Asurgical instrument, comprising: an elongate channel assembly having adistal end and a proximal end, said elongate channel assemblyconstructed to operably support a staple cartridge assembly therein; aknife assembly oriented for travel within said elongate channelassembly; at least one cable transition support operably mounted to atleast one of said elongate channel assembly and said knife assembly; adrive cable operably extending around at least a portion of said atleast one cable transition support and interfacing with a cable drivesystem to drive said knife assembly within said elongate channelassembly; and means for retaining said drive cable around said at leasta portion of said cable transition support.